Mary E Campbell, APRN, BC
Individual provider Active NPI Adult Health Nurse Practitioner · Dover, NH
NPI 1114109808 · NPPES record last updated Jan 15, 2019
Key facts
- NPI
- 1114109808
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Adult Health Nurse Practitioner 363LA2200X
- License
- 067174-23 (NH)
- Practice address
- 789 Central Ave
Dover, NH 03820-2526 - Phone
- (603) 742-8787
- NPI assigned
- Dec 4, 2007
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 164940 | MA | MD | Acute Care Nurse Practitioner |
| 067174-23 | NH | MD | Adult Health Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acute Care Nurse Practitioner | 363LA2100X | 164940 | MA | |
| Adult Health Nurse Practitioner | 363LA2200X | 067174-23 | NH | Yes |
Addresses
Primary practice location
789 Central Ave
Dover, NH 03820-2526
Mailing address
165 Ogunquit Rd
Cape Neddick, ME 03902-7938
Phone (207) 361-1593
Other practice location 1
55 Fruit St
Ellison 14 Room 1443
Boston, MA 02114-2621
Phone (617) 643-6922
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3100171 | Medicaid | NH |
Other providers in Dover, NH
- Trenton Alan Call
- Kevin Callaghan
- Jamie Lorraine Camello
- Catherine Ann Camire
- Campbell Dermatology PA
- Carolyn Canlas
- Laura Cannata
- Candice Cantalupo
- Leia Lindell Card
- Cassandre Cardillo
All providers in Dover, NH · Adult Health Nurse Practitioner in New Hampshire
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 15, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.