Provider Demographics
NPI:1245222413
Name:CAMPANIELLO, JEAN A (RNC, EDD)
Entity Type:Individual
Prefix:DR
First Name:JEAN
Middle Name:A
Last Name:CAMPANIELLO
Suffix:
Gender:F
Credentials:RNC, EDD
Other - Prefix:
Other - First Name:JEAN
Other - Middle Name:A
Other - Last Name:CAMPANIELLO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RNC, EDD
Mailing Address - Street 1:250 BOSTON TPKE
Mailing Address - Street 2:
Mailing Address - City:SHREWSBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01545-5265
Mailing Address - Country:US
Mailing Address - Phone:508-791-6809
Mailing Address - Fax:508-845-7407
Practice Address - Street 1:250 BOSTON TPKE
Practice Address - Street 2:
Practice Address - City:SHREWSBURY
Practice Address - State:MA
Practice Address - Zip Code:01545-5265
Practice Address - Country:US
Practice Address - Phone:508-791-6809
Practice Address - Fax:508-845-7407
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA71596163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAPN0014Medicare ID - Type Unspecified