Provider Demographics
NPI:1972263887
Name:CAMPOLI, KATARINA LOUISE (FNP-C)
Entity Type:Individual
Prefix:
First Name:KATARINA
Middle Name:LOUISE
Last Name:CAMPOLI
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:KATARINA
Other - Middle Name:LOUISE
Other - Last Name:HOLOWACZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:711 TROY SCHENECTADY RD STE 203
Mailing Address - Street 2:
Mailing Address - City:LATHAM
Mailing Address - State:NY
Mailing Address - Zip Code:12110-2461
Mailing Address - Country:US
Mailing Address - Phone:518-782-3700
Mailing Address - Fax:518-782-3799
Practice Address - Street 1:2125 RIVER RD STE 301
Practice Address - Street 2:
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12309-1136
Practice Address - Country:US
Practice Address - Phone:518-280-8470
Practice Address - Fax:518-280-8471
Is Sole Proprietor?:No
Enumeration Date:2021-12-20
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY348914363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily