Individual
MRS. JENNIFER D CAMPBELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
390 S MAIN ST, SUITE 101, ROCKY MOUNT, VA 24151-1711
(540) 484-4836
(540) 484-4837
Mailing address
271 LAYMANTOWN RD, TROUTVILLE, VA 24175-6715
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110-002031
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010137187
—
VA
05
—
010137233
—
VA
Enumeration date
11/10/2005
Last updated
04/30/2008
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