NPI 1518019769 · live from the CMS NPI Registry
Kathleen Susan Campbell, PAC
Physician Assistant in Burlington, VT. National Provider Identifier 1518019769, active.
NPI record
| NPI | 1518019769 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Physician Assistant 363A00000X |
| Practice location | 111 Colchester Ave, 125ba3, Burlington, VT 05401 |
| Practice phone | 802-847-8675 |
| Mailing address | 192 Tilley Dr, South Burlington, VT 05403 |
| Enumerated | January 17, 2007 |
| Last updated | April 13, 2010 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physician Assistant, Medical | 363AM0700X | 010548-1 (NY) |
| Physician Assistant primary | 363A00000X | 055-0030834 (VT) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.