Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 309909 | NY |
NPI | 1356941751 |
---|---|
Provider Name | Marie B Campbell |
First Address | Rochester, NY 14617-5504 |
Second Address | Batavia, NY 14020-1631 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/10/2020 |
Last Update Date | 06/05/2021 |