Individual
MRS. KYLIE ELIZABETH CAMPBELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4921 GOLDEN FOOTHILL PKWY, EL DORADO HILLS, CA 95762-9632
(916) 983-5771
(916) 939-1800
Mailing address
PO BOX 5156, EL DORADO HILLS, CA 95762-0003
(530) 400-9674
(916) 939-1800
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
19985
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
952979638
FEDERAL ID NUMBER
CA
Enumeration date
10/26/2008
Last updated
05/21/2020
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