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General NPI Number Information
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NPI Number | 1063524114
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Entity Type | Individual
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Provider Name | SUSAN DIANE CAMPBELL APRN,BS
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Gender | Female
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3340 WOODBURN RD
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City | ANNANDALE
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State | VA
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Zip | 22003-1202
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Country | US
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Telephone | 703-289-2781
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Fax | 703-289-2764
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Provider Business Mailing Address
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Address Line | 9104 ROARING SPRING LOOP
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City | BRISTOW
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State | VA
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Zip | 20136-2109
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Country | US
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Telephone | 703-392-1078
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Fax | 703-289-2764
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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 | 364SP0809X
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Taxonomy Name | Adult Psychiatric/Mental Health Clinical Nurse Specialist
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License Number | 0015000809
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License Number State | VA
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