Provider Demographics
NPI:1386703593
Name:CAMPBELL, SUZANNE HETZEL (APRN)
Entity type:Individual
Prefix:MRS
First Name:SUZANNE
Middle Name:HETZEL
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 WINDY WOODS CIR
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN
Mailing Address - State:CT
Mailing Address - Zip Code:06470-1029
Mailing Address - Country:US
Mailing Address - Phone:203-254-4000
Mailing Address - Fax:203-254-4126
Practice Address - Street 1:2505 MAIN ST
Practice Address - Street 2:SUITE 223
Practice Address - City:STRATFORD
Practice Address - State:CT
Practice Address - Zip Code:06615-5839
Practice Address - Country:US
Practice Address - Phone:203-375-5812
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002224363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health