Noel Chavis Campbell Jr.

Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Blakeslee, PA

NPI 1629660451 · NPPES record last updated Feb 3, 2021

Key facts

NPI
1629660451
Entity type
Individual (NPI type 1)
Primary specialty
Student in an Organized Health Care Education/Training Program 390200000X
Practice address
1618 Glacier Dr
Blakeslee, PA 18610-2109
Phone
(570) 982-7740
NPI assigned
Feb 3, 2021
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Yes

Addresses

Primary practice location

1618 Glacier Dr
Blakeslee, PA 18610-2109

Mailing address

1618 Glacier Dr
Blakeslee, PA 18610-2109

Other providers in Blakeslee, PA

All providers in Blakeslee, PA · Student in an Organized Health Care Education/Training Program in Pennsylvania

Sources for this page

Verify at the official NPI Registry.