Provider Demographics
NPI:1265460323
Name:CAMPBELL, MARGARET LORENE (PHD, RN)
Entity Type:Individual
Prefix:DR
First Name:MARGARET
Middle Name:LORENE
Last Name:CAMPBELL
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Gender:F
Credentials:PHD, RN
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Mailing Address - Street 1:18925 BIRCHCREST DR
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48221-2226
Mailing Address - Country:US
Mailing Address - Phone:313-341-3299
Mailing Address - Fax:313-745-3637
Practice Address - Street 1:DETROIT RECEIVING HOSPITAL
Practice Address - Street 2:4201 ST. ANTOINE
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48201
Practice Address - Country:US
Practice Address - Phone:313-745-3271
Practice Address - Fax:313-745-3637
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4704106856363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2003066Medicaid
MI0N63740Medicare ID - Type Unspecified