Individual
CANDACE CAMPBELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
182 16TH ST, BURLINGTON, CO 80807-1649
(719) 346-9481
(719) 346-9485
Mailing address
182 16TH ST, BURLINGTON, CO 80807-1649
(719) 346-4898
(719) 346-9485
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
1630
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
28659376
—
CO
Enumeration date
07/01/2005
Last updated
08/08/2012
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