Individual
MRS. KIMBERLY ANNE CAMPBELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
141 LONGWATER DR, NORWELL, MA 02061-1632
(781) 878-5200
Mailing address
143 LONGWATER DR, NORWELL, MA 02061-1683
(781) 878-5200
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
RN256606
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
042297845
TRICARE
—
05
—
110091947A
—
MA
01
—
1689940348
FALLON
—
01
—
SS0123
BCBSMA
—
Enumeration date
03/28/2012
Last updated
02/13/2014
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