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Individual

ELOISE CAMPBELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP,CDE,BC-ADM

Contact information

Practice address
920 DUPONT RD, LOUISVILLE, KY 40207-4692
(502) 895-2334
(502) 896-6987
Mailing address
3306 BREAUX DR, LOUISVILLE, KY 40220-2113

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
3003087
KY
363LA2200X
Adult Health Nurse Practitioner
71001251A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3003087
STATE LICENSE
KY
01
71001251A
STATE LICENSE
IN
Enumeration date
12/18/2006
Last updated
08/08/2013
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