Provider Demographics
NPI:1740476605
Name:CAMPBELL, SHERRI N (PA)
Entity type:Individual
Prefix:
First Name:SHERRI
Middle Name:N
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:252 CHAPMAN RD
Mailing Address - Street 2:SUITE 150
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19702-5438
Mailing Address - Country:US
Mailing Address - Phone:302-366-7665
Mailing Address - Fax:302-366-0734
Practice Address - Street 1:3105 LIMESTONE RD
Practice Address - Street 2:SUITE 202
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-2151
Practice Address - Country:US
Practice Address - Phone:302-994-6500
Practice Address - Fax:302-994-6922
Is Sole Proprietor?:No
Enumeration Date:2007-09-24
Last Update Date:2011-11-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
DEC50000323363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1740476605Medicaid
DE126856ZA7AMedicare PIN