Doctor Name: | CARLA CAMPBELL |
NPI Number: | 1003186677 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | NP-C |
License Number: | 12940 |
Business Practice Address: | 445 Centennial Ave Butte, MT - 597012870 |
Business Phone Number: | 4067234075 |
Business Fax Number: | 4067235060 |
Mailing Address: | 445 Centennial Ave, BUTTE |
State: | MT |
Postal Code: | 597012870 |
Phone Number: | 4067234075 |
Fax Number: | 4067235060 |
NPI Enumeration Date: | 01/12/2012 |
NPI Last Update Date: | 09/11/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 12940 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MT |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |