Provider Demographics
NPI:1336402866
Name:CAMPBELL, MARY ANNE (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:ANNE
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:MRS
Other - First Name:MARY
Other - Middle Name:ANNE
Other - Last Name:EHLAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:328 COCHRAN RD
Mailing Address - Street 2:
Mailing Address - City:MT LEBANON
Mailing Address - State:PA
Mailing Address - Zip Code:15228-1232
Mailing Address - Country:US
Mailing Address - Phone:724-929-9155
Mailing Address - Fax:
Practice Address - Street 1:328 COCHRAN RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15228-1232
Practice Address - Country:US
Practice Address - Phone:724-929-9155
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-19
Last Update Date:2021-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP017715363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily