Provider Demographics
NPI:1245326834
Name:CAMPBELL-RAWLE, LORNA LORETTA (CRNA)
Entity type:Individual
Prefix:MRS
First Name:LORNA
Middle Name:LORETTA
Last Name:CAMPBELL-RAWLE
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:MS
Other - First Name:LORNA
Other - Middle Name:
Other - Last Name:RAWLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:959 EAST 106 STREET
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11236
Mailing Address - Country:US
Mailing Address - Phone:718-495-6120
Mailing Address - Fax:
Practice Address - Street 1:150 55TH STREET
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220
Practice Address - Country:US
Practice Address - Phone:718-630-7476
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2023-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY437486367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered