MEDICARE: REBECCA MARIE CAMPANO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WP0200X	Pediatric Registered Nurse	RN567057	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	RN567057	OTHER	PA	NURSING LICENSE

General Provider Information

NPI Number	:	1497829964
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBECCA MARIE CAMPANO

Provider Business Mailing Address
First Line	:	4694 W SMITHFIELD ST
Second Line	:
City	:	MCKEESPORT
State	:	PA
Zip	:	15135-1208
Country	:	US
Telephone Number	:	412-678-1115
Fax Number	:

Provider Business Practice Location Address
First Line	:	4694 W SMITHFIELD ST
Second Line	:
City	:	MCKEESPORT
State	:	PA
Zip	:	15135-1208
Country	:	US
Telephone Number	:	412-678-1115
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/17/2006
Last Update Date	:	07/08/2007

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Directions to “ REBECCA MARIE CAMPANO ” Practice Location

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