Healthcare Provider Details

I. General information

NPI: 1649257775
Provider Name (Legal Business Name): PHILIP P CAMPBELL APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/29/2005
Last Update Date: 04/24/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

460 AMHERST ST
NASHUA NH
03063-1220
US

IV. Provider business mailing address

PO BOX 808
NASHUA NH
03061-0808
US

V. Phone/Fax

Practice location:
  • Phone: 603-883-7970
  • Fax:
Mailing address:
  • Phone:
  • Fax: 603-595-2997

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number038130-23-03
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: