Healthcare Provider Details

I. General information

NPI: 1831490283
Provider Name (Legal Business Name): CINDY JO CAMPBELL CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CINDY BOGART

II. Dates (important events)

Enumeration Date: 11/16/2010
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

137 FOREST HILL RD
MIFFLINBURG PA
17844-7066
US

IV. Provider business mailing address

7 DOCK HILL RD
MIDDLEBURG PA
17842-8910
US

V. Phone/Fax

Practice location:
  • Phone: 570-966-1004
  • Fax: 570-966-3736
Mailing address:
  • Phone: 570-837-2123
  • Fax: 570-837-2185

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberSP010926
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: