| Doctor Name: | MRS. JENNIFER CAMPBELL |
| NPI Number: | 1023232477 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CPNP |
| License Number: | 71000545A |
| Business Practice Address: | 1509 State Street La Porte, IN - 463503429 |
| Business Phone Number: | 2193243431 |
| Business Fax Number: | 2193623802 |
| Mailing Address: | P.o. Box 1690, LA PORTE |
| State: | IN |
| Postal Code: | 463521690 |
| Phone Number: | 2193262312 |
| Fax Number: | 2193262584 |
| NPI Enumeration Date: | 04/13/2007 |
| NPI Last Update Date: | 11/12/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0200X |
| License Number: | 71000545A |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IN |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |