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General NPI Number Information
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NPI Number | 1942784814
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Entity Type | Individual
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Provider Name | LISA MARIE CAMPBELL FNP
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Gender | Female
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Dates
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Enumeration Date | 09/18/2018
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Last Update Date | 12/15/2023
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Provider Practice Location Address
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Address Line | FAMILY HEALTH AND SURGERY CENTER 5700 COOPER FOSTER PARK ROAD
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City | LORAIN
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State | OH
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Zip | 44053
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Country | US
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Telephone | 440-695-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 1210 LAGUNA DR
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City | HURON
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State | OH
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Zip | 44839-2607
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Country | US
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Telephone | 419-656-2702
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F07182461
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License Number State | OH
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