Healthcare Provider Details

I. General information

NPI: 1740075076
Provider Name (Legal Business Name): VIRGINIA MARION CAMPBELL AGACNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2025
Last Update Date: 01/20/2026
Certification Date: 01/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 MEDICAL CENTER DR STE 3400
BRUNSWICK ME
04011-2675
US

IV. Provider business mailing address

121 MEDICAL CENTER DR STE 3400
BRUNSWICK ME
04011-2675
US

V. Phone/Fax

Practice location:
  • Phone: 207-406-7300
  • Fax: 207-835-4736
Mailing address:
  • Phone: 207-406-7300
  • Fax: 207-835-4736

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberCNP251098
License Number StateME
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberCNP251098
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: