Provider Demographics
NPI:1528338357
Name:CAMPBELL, KATHERINE L (CSA)
Entity type:Individual
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First Name:KATHERINE
Middle Name:L
Last Name:CAMPBELL
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Gender:F
Credentials:CSA
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Mailing Address - Street 1:7591 MOUNTAIN BREEZE
Mailing Address - Street 2:
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30134-3272
Mailing Address - Country:US
Mailing Address - Phone:404-273-2093
Mailing Address - Fax:
Practice Address - Street 1:7591 MOUNTAIN BREEZE
Practice Address - Street 2:
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30134-3272
Practice Address - Country:US
Practice Address - Phone:404-273-2093
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-10
Last Update Date:2024-05-02
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical