Provider Demographics
NPI:1225079387
Name:CAMPBELL, CORINNA LYNN (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:CORINNA
Middle Name:LYNN
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3655 ROUTE 202
Mailing Address - Street 2:SUITE 225
Mailing Address - City:DOYLESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18902
Mailing Address - Country:US
Mailing Address - Phone:215-230-4013
Mailing Address - Fax:215-230-4143
Practice Address - Street 1:3655 ROUTE 202
Practice Address - Street 2:SUITE 225
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18902
Practice Address - Country:US
Practice Address - Phone:215-230-4013
Practice Address - Fax:215-230-4143
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA002455L363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAMC0336570OtherDEA
PAS47444Medicare UPIN
PA073397Medicare ID - Type Unspecified