Provider Demographics
NPI:1053554287
Name:CAMPBELL, ELIZABETH A (NP)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:A
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:2300 N EDWARD ST
Mailing Address - Street 2:GSBLL
Mailing Address - City:DECATUR
Mailing Address - State:IL
Mailing Address - Zip Code:62526-4163
Mailing Address - Country:US
Mailing Address - Phone:217-876-2857
Mailing Address - Fax:217-876-2874
Practice Address - Street 1:150 S FAIRVIEW AVE
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:IL
Practice Address - Zip Code:62522-2852
Practice Address - Country:US
Practice Address - Phone:217-424-6360
Practice Address - Fax:217-422-5542
Is Sole Proprietor?:No
Enumeration Date:2009-04-17
Last Update Date:2014-09-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL209000549363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily