Provider Demographics
NPI:1851346779
Name:CAMPBELL, CINDY D (ANP)
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:D
Last Name:CAMPBELL
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 1:4320 DIPLOMACY DR
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-5925
Mailing Address - Country:US
Mailing Address - Phone:907-729-4230
Mailing Address - Fax:
Practice Address - Street 1:4320 DIPLOMACY DR
Practice Address - Street 2:STE 1500
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-5925
Practice Address - Country:US
Practice Address - Phone:907-729-4230
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2014-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK865363LP0808X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
8EC799Medicare ID - Type Unspecified
AK8EL718Medicare PIN
S00802Medicare UPIN
AK8EL716Medicare PIN
AK8EL616Medicare PIN
AKNP0327Medicaid
AK8EL717Medicare PIN
AK8EL719Medicare PIN
AK8EL720Medicare PIN
AK8EL617Medicare PIN
AK8EL118Medicare PIN