Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | 9720 | NH |
NPI | 1114947934 |
---|---|
Provider Name | Dr. Patricia Isabel Campbell |
First Address | Keene, NH 03431-1719 |
Second Address | Keene, NH 03431-1719 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/07/2006 |
Last Update Date | 27/10/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
30009776 | (05) | NH |
G34074 | (02) |