Provider Demographics
NPI:1780664680
Name:CAMPTON, CHRISTINE MARIE (NP)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:MARIE
Last Name:CAMPTON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1555 MERRILL ST
Mailing Address - Street 2:SPC 174
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95062-4025
Mailing Address - Country:US
Mailing Address - Phone:520-403-6345
Mailing Address - Fax:
Practice Address - Street 1:23625 HOLMAN HWY
Practice Address - Street 2:
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-5902
Practice Address - Country:US
Practice Address - Phone:831-622-8017
Practice Address - Fax:831-622-8066
Is Sole Proprietor?:No
Enumeration Date:2006-01-18
Last Update Date:2013-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN030691363LG0600X
CANPF16312363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAP00400320OtherRR MEDICARE
CANP0163120Medicaid
CAP00400320OtherRR MEDICARE