Provider Demographics
NPI:1073958328
Name:CAMPBELL, JENNIFER L (RPH)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:L
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 RIVER RD
Mailing Address - Street 2:
Mailing Address - City:STEAMBOAT SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80487-9307
Mailing Address - Country:US
Mailing Address - Phone:970-846-1591
Mailing Address - Fax:
Practice Address - Street 1:840 LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:STEAMBOAT SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80487-5005
Practice Address - Country:US
Practice Address - Phone:970-879-1114
Practice Address - Fax:970-879-5643
Is Sole Proprietor?:No
Enumeration Date:2013-04-30
Last Update Date:2021-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO15336183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist