Provider Demographics
NPI:1255390969
Name:CAMPBELL, BRIAN D (CRNA)
Entity type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:D
Last Name:CAMPBELL
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
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Mailing Address - Street 1:14 TOWNSEND ST
Mailing Address - Street 2:
Mailing Address - City:MALDEN
Mailing Address - State:MA
Mailing Address - Zip Code:02148-6323
Mailing Address - Country:US
Mailing Address - Phone:781-397-8906
Mailing Address - Fax:781-397-1686
Practice Address - Street 1:41 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:MA
Practice Address - Zip Code:01890-1446
Practice Address - Country:US
Practice Address - Phone:781-756-2012
Practice Address - Fax:781-756-2975
Is Sole Proprietor?:No
Enumeration Date:2006-03-21
Last Update Date:2010-08-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA145986367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered