| Doctor Name: | MRS. JENNIFER SUE CAMPOS |
| NPI Number: | 1043581820 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP-BC, CCRN, CMC |
| License Number: | 209009255 |
| Business Practice Address: | 405 W Jackson St Carbondale, IL - 629011462 |
| Business Phone Number: | 6185490721 |
| Business Fax Number: | |
| Mailing Address: | 405 W Jackson, CARBONDALE |
| State: | IL |
| Postal Code: | 629011462 |
| Phone Number: | 6185490721 |
| Fax Number: | |
| NPI Enumeration Date: | 01/25/2012 |
| NPI Last Update Date: | 01/25/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 209009255 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |