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General NPI Number Information
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NPI Number | 1205712734
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Entity Type | Individual
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Provider Name | SHARON ELLIS CAMPBELL PMHNP
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Gender | Female
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Dates
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Enumeration Date | 08/12/2025
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Last Update Date | 08/12/2025
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Provider Practice Location Address
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Address Line | 15 RIDGECREST CIR
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City | LEWISBURG
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State | PA
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Zip | 17837-6367
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Country | US
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Telephone | 718-506-1115
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Fax |
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Provider Business Mailing Address
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Address Line | 455 ANTS HILL RD
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City | BLOOMSBURG
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State | PA
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Zip | 17815-6561
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Country | US
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Telephone |
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Fax |
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | RN315808L
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License Number State | PA
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