Healthcare Provider Details

I. General information

NPI: 1841015385
Provider Name (Legal Business Name): JULIANA CAMPANELLA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/19/2024
Last Update Date: 03/18/2025
Certification Date: 03/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

420 FRONT ST
ELMER NJ
08318-2177
US

IV. Provider business mailing address

5 PEPPERTREE CT
SEWELL NJ
08080-2104
US

V. Phone/Fax

Practice location:
  • Phone: 856-358-1500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP031400
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: