Stacy Laura Campbell PA-C

NPI 1720163918 - Physician Assistant - 363A00000X

NPI Details
NPI 1720163918
Gender Female
Enumeration Date 10/26/2006
Last Updated 09/04/2013
Entity Type Individual
Active Over 10 years ago
Practice Location
145 MICHIGAN ST NE
SUITE 5500
GRAND RAPIDS MI, 49503-2562, US
Phone (616) 486-5961
Fax
Business Location
100 MICHIGAN ST NE
MC 845
GRAND RAPIDS MI, 49503-2560, US
Phone
Fax
Toxanomy
Taxonomy Code 363A00000X
License State Michigan
License Number 5601005866
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According to our database, Stacy Laura Campbell PA-C NPI is 1720163918, taxonomy code is 363A00000X and license number is 5601005866, license state is located at Michigan. Stacy Laura Campbell PA-C physically located at 145 Michigan St Ne, Grand Rapids MI, 49503-2562. NPI Number Stacy Laura Campbell PA-C has the Individual type.

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1720163918 NPI number is provided on an as is basis without warranty of any kind. 1720163918 is maintained by the National Plan & Provider Enumeration System. The contents of Stacy Laura Campbell PA-C are for informational purposes only.