Healthcare Provider Details

I. General information

NPI: 1114984580
Provider Name (Legal Business Name): DIANE E CAMPTON RN
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 04/28/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1608 HILLSIDE ROAD
CAMBRIDGE WI
53523
US

IV. Provider business mailing address

2908 RIVERSIDE
BELOIT WI
53511
US

V. Phone/Fax

Practice location:
  • Phone: 608-423-3489
  • Fax:
Mailing address:
  • Phone: 608-362-7940
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number67975030
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number67975030
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: