Provider Demographics
NPI:1811921562
Name:CAMPERLINO, JUDITH A (CRNA)
Entity type:Individual
Prefix:
First Name:JUDITH
Middle Name:A
Last Name:CAMPERLINO
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:JUDITH
Other - Middle Name:
Other - Last Name:CAMPERLINO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:P.O. BOX 4169
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19807
Mailing Address - Country:US
Mailing Address - Phone:302-995-1860
Mailing Address - Fax:302-995-5421
Practice Address - Street 1:4745 OGLETOWN STANTON RD STE 134
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-2074
Practice Address - Country:US
Practice Address - Phone:302-738-5300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2019-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL6-0A00278367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
DEP00128900OtherRAILROAD MEDICARE
DE012686O50Medicare PIN