Provider Demographics
NPI:1548259831
Name:CAMPBELL, EILEEN F (APN)
Entity type:Individual
Prefix:MS
First Name:EILEEN
Middle Name:F
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 FEDERAL ST STE SW200
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08103-1155
Mailing Address - Country:US
Mailing Address - Phone:856-356-4924
Mailing Address - Fax:
Practice Address - Street 1:318 WHITE HORSE PIKE
Practice Address - Street 2:
Practice Address - City:HADDON HEIGHTS
Practice Address - State:NJ
Practice Address - Zip Code:08035-1705
Practice Address - Country:US
Practice Address - Phone:856-547-6000
Practice Address - Fax:856-546-3189
Is Sole Proprietor?:No
Enumeration Date:2005-10-19
Last Update Date:2018-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NN053655363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8713308Medicaid
045599SK3Medicare PIN
077356Medicare Oscar/Certification
NJP25601Medicare UPIN