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Individual

SUSAN L CAMPBELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CNM

Contact information

Practice address
2131 EAST STATE ST., ATHENS, OH 45701
(740) 589-3100
(740) 589-3123
Mailing address
90 JACKSON PIKE, GALLIPOLIS, OH 45631-1560
(740) 589-3100
(740) 589-3123

Taxonomy

Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
APRN.CNM.10196
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000259823
OH MEDICAID UNISON
OH
01
2882288
OH MEDICAID MOLINA
OH
05
2882288
OH
01
310917085201
OH MEDICAID CARESOURCE
OH
05
3810013422
WV
01
P00665594
RAILROAD MEDICARE
Enumeration date
08/02/2005
Last updated
11/09/2017
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