Provider Demographics
NPI:1891976049
Name:CAMPBELL, LOIS P (REGISTERED NURSE)
Entity Type:Individual
Prefix:
First Name:LOIS
Middle Name:P
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:422 DUNHAM AVE
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:NY
Mailing Address - Zip Code:10553-2006
Mailing Address - Country:US
Mailing Address - Phone:914-699-7226
Mailing Address - Fax:914-699-7226
Practice Address - Street 1:422 DUNHAM AVE
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:NY
Practice Address - Zip Code:10553-2006
Practice Address - Country:US
Practice Address - Phone:914-699-7226
Practice Address - Fax:914-699-7226
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-15
Last Update Date:2007-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY4237561163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse