Individual
MRS. JENNIFER CAMPBELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
1509 STATE STREET, LA PORTE, IN 46350-3429
(219) 324-3431
(219) 362-3802
Mailing address
P.O. BOX 1690, LA PORTE, IN 46352-1690
(219) 326-2312
(219) 326-2584
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
71000545A
IN
Other
Enumeration date
04/13/2007
Last updated
11/12/2010
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