| NPI | 1326370438 | 
|---|---|
| Former Name | KIMBERLY BROOKE CAMPBELL | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: VA 0110-003169)  | 
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-03823)  | 
| 363A00000X Physician Assistant (Licence: VA 0110003169)  | |
| 363A00000X Physician Assistant (Licence: WV 488)  | |
| 363AM0700X Physician Assistant, Medical (Licence: VA 0110-002169)  | |
| Enumeration Date | 2010-02-01 | 
| Last Update Date | 2024-02-27 |