Provider Demographics
NPI:1225848690
Name:CAMPOS, ABIGALE LOUISE (PA-C)
Entity type:Individual
Prefix:MRS
First Name:ABIGALE
Middle Name:LOUISE
Last Name:CAMPOS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ABIGALE
Other - Middle Name:LOUISE
Other - Last Name:WHITSELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:500 UNIVERSITY DRIVE
Mailing Address - Street 2:MC CA410
Mailing Address - City:HERSHEY
Mailing Address - State:PA
Mailing Address - Zip Code:17033-1455
Mailing Address - Country:US
Mailing Address - Phone:800-243-1455
Mailing Address - Fax:
Practice Address - Street 1:500 UNIVERSITY DRIVE
Practice Address - Street 2:MC CA410
Practice Address - City:HERSHEY
Practice Address - State:PA
Practice Address - Zip Code:17033-1455
Practice Address - Country:US
Practice Address - Phone:800-243-1455
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-08
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA066188363AM0700X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical