MEDICARE: MS. NANCY P CAMPBELL MSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	I4824	OH

General Provider Information

NPI Number	:	1548379134
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. NANCY P CAMPBELL MSW

Provider Business Mailing Address
First Line	:	7971 TWIN CREEK TRCE
Second Line	:
City	:	WEST CHESTER
State	:	OH
Zip	:	45069-2274
Country	:	US
Telephone Number	:	513-779-2041
Fax Number	:

Provider Business Practice Location Address
First Line	:	11500 NORTHLAKE DR
Second Line	:	SUITE 200
City	:	CINCINNATI
State	:	OH
Zip	:	45249-1650
Country	:	US
Telephone Number	:	513-247-4634
Fax Number	:	513-247-4620

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/29/2006
Last Update Date	:	07/08/2007

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