Provider Demographics
NPI:1659868487
Name:CAMPBELL, HOLLIE ELIZABETH (PNP)
Entity Type:Individual
Prefix:MRS
First Name:HOLLIE
Middle Name:ELIZABETH
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:MISS
Other - First Name:HOLLIE
Other - Middle Name:ELIZABETH
Other - Last Name:RINALDO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5051 EMERSON RD
Mailing Address - Street 2:
Mailing Address - City:CANANDAIGUA
Mailing Address - State:NY
Mailing Address - Zip Code:14424-8014
Mailing Address - Country:US
Mailing Address - Phone:585-260-2016
Mailing Address - Fax:
Practice Address - Street 1:725 IRVING AVE STE 503
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13210-1683
Practice Address - Country:US
Practice Address - Phone:315-464-4418
Practice Address - Fax:315-464-4415
Is Sole Proprietor?:No
Enumeration Date:2018-04-17
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY382749363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics