Provider Demographics
NPI:1831088517
Name:CAMPBELL, MARISA (RN,BSN)
Entity type:Individual
Prefix:
First Name:MARISA
Middle Name:
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:RN,BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4980 N MAIN ST APT 816
Mailing Address - Street 2:
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02720-2046
Mailing Address - Country:US
Mailing Address - Phone:781-812-3772
Mailing Address - Fax:
Practice Address - Street 1:4980 N MAIN ST APT 816
Practice Address - Street 2:
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02720-2046
Practice Address - Country:US
Practice Address - Phone:781-812-3772
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-30
Last Update Date:2025-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2356308163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse