MEDICARE: CHRISTINE MARIE CAMPTON NP

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	363LG0600X	Gerontology Nurse Practitioner	RN030691	AZ
2	363LG0600X	Gerontology Nurse Practitioner	NPF16312	CA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00400320	OTHER	CA	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1780664680
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINE MARIE CAMPTON NP

Provider Business Mailing Address
First Line	:	1555 MERRILL ST
Second Line	:	SPC 174
City	:	SANTA CRUZ
State	:	CA
Zip	:	95062-4025
Country	:	US
Telephone Number	:	520-403-6345
Fax Number	:

Provider Business Practice Location Address
First Line	:	23625 HOLMAN HWY
Second Line	:
City	:	MONTEREY
State	:	CA
Zip	:	93940-5902
Country	:	US
Telephone Number	:	831-622-8017
Fax Number	:	831-622-8066

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

Provider Enumeration Date	:	01/18/2006
Last Update Date	:	06/18/2013

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