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Individual
TERESA R CAMPBELL
Active
Individual
TERESA R CAMPBELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA13619
CA
363L00000X
Nurse Practitioner
NP7094C
CA
363LF0000X
Family Nurse Practitioner
7094
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA13619
MEDICAL LICENSE
CA
Enumeration date
01/17/2007
Last updated
05/06/2016
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