Provider Demographics
NPI:1497893523
Name:MUIR, MARISA CAMPANA (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:MARISA
Middle Name:CAMPANA
Last Name:MUIR
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:MARISA
Other - Middle Name:A
Other - Last Name:CAMPANA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:2938 KNIGHTS RD
Mailing Address - Street 2:
Mailing Address - City:BENSALEM
Mailing Address - State:PA
Mailing Address - Zip Code:19020-3574
Mailing Address - Country:US
Mailing Address - Phone:215-639-1460
Mailing Address - Fax:215-639-6653
Practice Address - Street 1:2938 KNIGHTS RD
Practice Address - Street 2:
Practice Address - City:BENSALEM
Practice Address - State:PA
Practice Address - Zip Code:19020-3574
Practice Address - Country:US
Practice Address - Phone:215-639-1460
Practice Address - Fax:215-639-6653
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2020-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA051919363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical