| Doctor Name: | MS. SUSAN DIANE CAMPBELL |
| NPI Number: | 1063524114 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | APRN,BS |
| License Number: | 0015000809 |
| Business Practice Address: | 3340 Woodburn Rd Annandale, VA - 220031202 |
| Business Phone Number: | 7032892781 |
| Business Fax Number: | 7032892764 |
| Mailing Address: | 9104 Roaring Spring Loop, BRISTOW |
| State: | VA |
| Postal Code: | 201362109 |
| Phone Number: | 7033921078 |
| Fax Number: | 7032892764 |
| NPI Enumeration Date: | 08/31/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 364SP0809X |
| License Number: | 0015000809 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Clinical Nurse Specialist |
| Taxonomy Specialization: | Psych/Mental Health, Adult |
| Taxonomy Definition: | |