Individual
MS. MARY JANE CAMPBELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1910 MALVERN AVE, HOT SPRINGS, AR 71901-7752
(501) 321-1000
Mailing address
PO BOX 22390, HOT SPRINGS, AR 71903-2390
(800) 235-1415
(913) 234-1108
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
C01047
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5T343
AR BCBS
AR
Enumeration date
09/23/2005
Last updated
03/27/2008
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