| NPI | 1619203270 |
|---|---|
| Former Name | CARRISSA BETH CAMPBELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: ME CNP91062) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: ME AP091062) |
| Enumeration Date | 2009-11-02 |
| Last Update Date | 2019-06-05 |