Provider Demographics
NPI:1205922762
Name:CAMPBELL, MONIQUE J (RN)
Entity type:Individual
Prefix:MRS
First Name:MONIQUE
Middle Name:J
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 COURT STREET
Mailing Address - Street 2:
Mailing Address - City:HOULTON
Mailing Address - State:ME
Mailing Address - Zip Code:04730
Mailing Address - Country:US
Mailing Address - Phone:207-532-0566
Mailing Address - Fax:
Practice Address - Street 1:59 BANGOR STREET
Practice Address - Street 2:
Practice Address - City:HOULTON
Practice Address - State:ME
Practice Address - Zip Code:04730
Practice Address - Country:US
Practice Address - Phone:207-521-0022
Practice Address - Fax:207-521-0066
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MER040633163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health