Provider Demographics
NPI:1790704385
Name:CAMPANA, JANET E (ANP)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:E
Last Name:CAMPANA
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 200149
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99520-0149
Mailing Address - Country:US
Mailing Address - Phone:907-561-3211
Mailing Address - Fax:907-562-7547
Practice Address - Street 1:3841 PIPER STREET
Practice Address - Street 2:SUITE T100
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508
Practice Address - Country:US
Practice Address - Phone:907-561-3211
Practice Address - Fax:907-562-7547
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2007-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK546363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKNP8545Medicaid
AKK150600Medicare PIN
S70716Medicare UPIN