Provider Demographics
NPI:1568428290
Name:CAMPBELL, KAREN (CRNP-DNP)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:CRNP-DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3150 MOUNT MORRIS RD
Mailing Address - Street 2:
Mailing Address - City:WAYNESBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15370-2275
Mailing Address - Country:US
Mailing Address - Phone:724-833-9377
Mailing Address - Fax:724-833-9175
Practice Address - Street 1:3150 MOUNT MORRIS RD
Practice Address - Street 2:
Practice Address - City:WAYNESBURG
Practice Address - State:PA
Practice Address - Zip Code:15370-2275
Practice Address - Country:US
Practice Address - Phone:724-833-9377
Practice Address - Fax:724-833-9175
Is Sole Proprietor?:No
Enumeration Date:2006-04-21
Last Update Date:2017-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV14362363LF0000X
PASP009535363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA122713XRNMedicare UPIN
PA122713XRUMedicare UPIN