Provider Demographics
NPI:1881813525
Name:CAMPISI, ANDREA VALLE (RN, MSN, CNOR)
Entity type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:VALLE
Last Name:CAMPISI
Suffix:
Gender:F
Credentials:RN, MSN, CNOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5716 BIRCH POINT CT
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95757-8318
Mailing Address - Country:US
Mailing Address - Phone:916-686-5006
Mailing Address - Fax:916-453-5842
Practice Address - Street 1:2801 L ST
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816-5615
Practice Address - Country:US
Practice Address - Phone:916-733-3050
Practice Address - Fax:916-453-5842
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA438243163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse