Basic Information
| Provider Information | |||||||||
| NPI: | 1538297064 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CAMPBELL | ||||||||
| FirstName: | JOHN | ||||||||
| MiddleName: | B | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | CRNA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 38249 YACHT BASIN ROAD | ||||||||
| Address2: | UNIT 20 | ||||||||
| City: | OCEAN VIEW | ||||||||
| State: | DE | ||||||||
| PostalCode: | 19970 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3025374847 | ||||||||
| FaxNumber: | 3025374847 | ||||||||
| Practice Location | |||||||||
| Address1: | 801 MIDDLEFORD RD | ||||||||
| Address2: | |||||||||
| City: | SEAFORD | ||||||||
| State: | DE | ||||||||
| PostalCode: | 199733636 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3026296611 | ||||||||
| FaxNumber: | 3026294758 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/28/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | L1-0019978 | DE | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
No ID Information.