Healthcare Provider Details

I. General information

NPI: 1568428290
Provider Name (Legal Business Name): KAREN CAMPBELL CRNP-DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/21/2006
Last Update Date: 12/19/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3150 MOUNT MORRIS RD
WAYNESBURG PA
15370-2275
US

IV. Provider business mailing address

3150 MOUNT MORRIS RD
WAYNESBURG PA
15370-2275
US

V. Phone/Fax

Practice location:
  • Phone: 724-833-9377
  • Fax: 724-833-9175
Mailing address:
  • Phone: 724-833-9377
  • Fax: 724-833-9175

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number14362
License Number StateWV
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP009535
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: