Provider Demographics
NPI:1306288758
Name:CAMPBELL, CHRISTINA R (CNP)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:R
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:CHRISTINA
Other - Middle Name:R
Other - Last Name:KUREK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:921 JASONWAY AVE STE B
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43214-2456
Mailing Address - Country:US
Mailing Address - Phone:614-268-8800
Mailing Address - Fax:614-447-8876
Practice Address - Street 1:921B JASONWAY AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-2330
Practice Address - Country:US
Practice Address - Phone:614-268-8800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-26
Last Update Date:2023-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.341690363LX0001X
OHAPRN.CNP.15095363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0088439Medicaid