Provider Demographics
NPI:1245411651
Name:CAMPBELL, NANCY GAIL
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:GAIL
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6636 SANTOLINA PL
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91739-1911
Mailing Address - Country:US
Mailing Address - Phone:909-717-9192
Mailing Address - Fax:
Practice Address - Street 1:6636 SANTOLINA PL
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91739-1911
Practice Address - Country:US
Practice Address - Phone:909-717-9192
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-14
Last Update Date:2013-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies