Individual
MARY SUSAN CAMPBELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1010 SW COAST HWY, SUITE 203, NEWPORT, OR 97365-5288
(541) 265-4947
(541) 574-7670
Mailing address
1010 SW COAST HWY, STE 203, NEWPORT, OR 97365-5215
(573) 210-1010
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209015842
IL
363LF0000X
Family Nurse Practitioner
137448
MO
363LF0000X
Family Nurse Practitioner
201600925NP-PP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1346321577
—
MO
05
—
428755920
—
MO
Enumeration date
10/17/2006
Last updated
05/24/2018
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