Provider Demographics
NPI:1891922506
Name:CAMPBELL, DANIELLE NICOLE (DO)
Entity Type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:NICOLE
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3421 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-9001
Mailing Address - Country:US
Mailing Address - Phone:717-812-5229
Mailing Address - Fax:717-266-7453
Practice Address - Street 1:235 ROSEDALE DR
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:PA
Practice Address - Zip Code:17345
Practice Address - Country:US
Practice Address - Phone:717-812-5229
Practice Address - Fax:717-266-7453
Is Sole Proprietor?:No
Enumeration Date:2009-06-19
Last Update Date:2019-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS015523207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA246077YUNMMedicare PIN
PA246077YEBKMedicare PIN