Provider Demographics
NPI:1841313574
Name:CAMPBELL, ANN L (NP)
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:L
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:7605 SAWMILL RD
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53717-2208
Mailing Address - Country:US
Mailing Address - Phone:608-265-9936
Mailing Address - Fax:608-263-6884
Practice Address - Street 1:1552 UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53726-4084
Practice Address - Country:US
Practice Address - Phone:608-265-9936
Practice Address - Fax:608-263-6884
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2158-033363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI2158-033OtherADVANCED PRACTICE NURSE P