Provider Demographics
NPI:1467645127
Name:CAMPBELL, PATRICIA (ANP)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 N 12TH ST STE 301
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85006-2813
Mailing Address - Country:US
Mailing Address - Phone:602-839-6968
Mailing Address - Fax:602-839-4144
Practice Address - Street 1:1300 N 12TH ST STE 301
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85006-2813
Practice Address - Country:US
Practice Address - Phone:602-839-6968
Practice Address - Fax:602-839-4144
Is Sole Proprietor?:No
Enumeration Date:2007-08-24
Last Update Date:2013-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN056640363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health