Healthcare Provider Details

I. General information

NPI: 1225694870
Provider Name (Legal Business Name): ASHLEY NICOLE CAMPBELL PHARMD, RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2019
Last Update Date: 05/18/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2821 1ST AVE SE
CEDAR RAPIDS IA
52402-4806
US

IV. Provider business mailing address

2821 1ST AVE SE
CEDAR RAPIDS IA
52402-4806
US

V. Phone/Fax

Practice location:
  • Phone: 319-365-3606
  • Fax: 319-365-0240
Mailing address:
  • Phone: 319-365-6306
  • Fax: 319-365-0240

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number23161
License Number StateIA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: