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Individual

ANDREA NICOLE CAMPBELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
P.A.

Contact information

Practice address
133 ENTERPRISE DR, DANVILLE, VA 24540-4071
(434) 792-2907
(434) 792-2542
Mailing address
133 ENTERPRISE DRIVE, DANVILLE, VA 24541-1679
(434) 792-2907
(434) 792-2542

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110004082
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0110004082
VIRGINIA LICENSES
VA
Enumeration date
11/15/2012
Last updated
03/20/2015
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