Provider Demographics
NPI:1497308241
Name:CAMPBELL, ERIN (RDN)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:903 CARLOS DR
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59404-3701
Mailing Address - Country:US
Mailing Address - Phone:260-213-0031
Mailing Address - Fax:
Practice Address - Street 1:600 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59401-3179
Practice Address - Country:US
Practice Address - Phone:406-952-3772
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-22
Last Update Date:2021-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTMED-NUTR-LIC-77913133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered