Individual
MRS. KAREN MARIE CAMPBELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
501 AIRPORT RD, RIFLE, CO 81650-8510
(970) 625-1100
Mailing address
501 AIRPORT RD, RIFLE, CO 81650-8510
(970) 625-1100
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2566
CO
363A00000X
Physician Assistant
6019995-1206
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1018636
AAPA FELLOW ID
—
01
—
12323701
CAQH
—
01
—
2566
COLORADO STATE LICENSE
CO
01
—
6019995-1206
PA STATE LICENSE NUMBER
UT
01
—
6019995-8906
PA CS SCHEDULE 2-5 LICENS
UT
Enumeration date
05/18/2007
Last updated
02/14/2020
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