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General NPI Number Information
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NPI Number | 1558511212
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Entity Type | Individual
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Provider Name | PATRICIA ANN CAMPBELL PA-C, RDN
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Gender | Female
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Dates
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Enumeration Date | 09/30/2008
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Last Update Date | 09/08/2025
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Provider Practice Location Address
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Address Line | 1875 WOODWINDS DR
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City | WOODBURY
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State | MN
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Zip | 55125-2298
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Country | US
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Telephone | 612-625-8690
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Fax |
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Provider Business Mailing Address
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Address Line | 1875 WOODWINDS DR
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City | WOODBURY
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State | MN
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Zip | 55125-2298
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Country | US
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Telephone | 612-625-8690
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Fax | 651-326-9667
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 3249
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 14527
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License Number State | MN
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