| Doctor Name: | MR. NICHOLAS J CAMPO |
| NPI Number: | 1003071499 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | NP |
| License Number: | 1147 |
| Business Practice Address: | 233 Sw Wilson Ave Ste 201 Bend, OR - 977022988 |
| Business Phone Number: | 2252873828 |
| Business Fax Number: | 2257696794 |
| Mailing Address: | 233 Sw Wilson Ave Ste 201, BEND |
| State: | OR |
| Postal Code: | 977022988 |
| Phone Number: | 2252873828 |
| Fax Number: | 2257696794 |
| NPI Enumeration Date: | 07/24/2008 |
| NPI Last Update Date: | 03/04/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0808X |
| License Number: | 1147 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | AK |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |