Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | 86 | AZ |
N | 363LX0001X | Nurse Practitioner - Obstetrics & Gynecology | 86 | AZ |
NPI | 1053314369 |
---|---|
Provider Name | Sharon R Campbell |
First Address | Tucson, AZ 85733-3100 |
Second Address | Tucson, AZ 85741-2107 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2005 |
Last Update Date | 14/11/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
192914 | (05) | AZ |
S50672 | (02) |