Provider Demographics
NPI:1538463021
Name:CAMPBELL, LINDA L (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:L
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:621 KELLY BLVD
Mailing Address - Street 2:
Mailing Address - City:SLIPPERY ROCK
Mailing Address - State:PA
Mailing Address - Zip Code:16057-8523
Mailing Address - Country:US
Mailing Address - Phone:724-794-4009
Mailing Address - Fax:724-794-4099
Practice Address - Street 1:621 KELLY BLVD
Practice Address - Street 2:
Practice Address - City:SLIPPERY ROCK
Practice Address - State:PA
Practice Address - Zip Code:16057-8523
Practice Address - Country:US
Practice Address - Phone:724-794-4009
Practice Address - Fax:724-794-4099
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-27
Last Update Date:2010-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAUP000071A363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care