Healthcare Provider Details

I. General information

NPI: 1326763319
Provider Name (Legal Business Name): MAUREEN CAMPBELL NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/11/2022
Last Update Date: 10/11/2022
Certification Date: 10/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 UNIVERSITY AVE STE 120
SACRAMENTO CA
95825-6532
US

IV. Provider business mailing address

1755 4TH AVE
SACRAMENTO CA
95818-3027
US

V. Phone/Fax

Practice location:
  • Phone: 916-929-8564
  • Fax:
Mailing address:
  • Phone: 916-201-3613
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95022960
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: