Provider Demographics
NPI:1922719491
Name:CAMPBELL, MARAH DANIELLE
Entity Type:Individual
Prefix:
First Name:MARAH
Middle Name:DANIELLE
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:824 CALIFORNIA AVE
Mailing Address - Street 2:
Mailing Address - City:AVALON
Mailing Address - State:PA
Mailing Address - Zip Code:15202-2706
Mailing Address - Country:US
Mailing Address - Phone:412-766-3232
Mailing Address - Fax:412-766-4320
Practice Address - Street 1:2562 CONSTITUTION BLVD
Practice Address - Street 2:
Practice Address - City:BEAVER FALLS
Practice Address - State:PA
Practice Address - Zip Code:15010-1249
Practice Address - Country:US
Practice Address - Phone:724-846-4934
Practice Address - Fax:412-766-4320
Is Sole Proprietor?:No
Enumeration Date:2022-12-06
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0032612363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily