Provider Demographics
NPI:1912416132
Name:CAMPBELL, MEGAN KRMPOTICH (FNP)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:KRMPOTICH
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:MARIE
Other - Last Name:KRMPOTICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5550 CADDIS BND APT 107
Mailing Address - Street 2:
Mailing Address - City:FITCHBURG
Mailing Address - State:WI
Mailing Address - Zip Code:53711-7141
Mailing Address - Country:US
Mailing Address - Phone:303-990-1631
Mailing Address - Fax:
Practice Address - Street 1:750 UNIVERSITY ROW
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53705-1311
Practice Address - Country:US
Practice Address - Phone:608-263-8094
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-20
Last Update Date:2021-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI8005363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily