Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 798666 | TX |
NPI | 1003185042 |
---|---|
Provider Name | Jennifer Lynn Campbell |
First Address | Frisco, TX 75033-4451 |
Second Address | Dallas, TX 75390-8879 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/12/2011 |
Last Update Date | 20/12/2011 |