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General NPI Number Information
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NPI Number | 1063413029
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Entity Type | Individual
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Provider Name | SUSAN L CAMPBELL CNM
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Gender | Female
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Dates
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Enumeration Date | 08/02/2005
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Last Update Date | 11/09/2017
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Provider Practice Location Address
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Address Line | 2131 EAST STATE ST.
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City | ATHENS
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State | OH
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Zip | 45701
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Country | US
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Telephone | 740-589-3100
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Fax | 740-589-3123
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Provider Business Mailing Address
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Address Line | 90 JACKSON PIKE
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City | GALLIPOLIS
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State | OH
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Zip | 45631-1560
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Country | US
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Telephone | 740-589-3100
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Fax | 740-589-3123
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number | APRN.CNM.10196
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License Number State | OH
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