Provider Demographics
NPI:1992785984
Name:CAMPBELL, LINDA STRICKLER (GNP)
Entity type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:STRICKLER
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:GNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 378
Mailing Address - Street 2:
Mailing Address - City:DOWAGIAC
Mailing Address - State:MI
Mailing Address - Zip Code:49047-0378
Mailing Address - Country:US
Mailing Address - Phone:269-782-2111
Mailing Address - Fax:269-782-9852
Practice Address - Street 1:400 W DIVISION ST
Practice Address - Street 2:
Practice Address - City:DOWAGIAC
Practice Address - State:MI
Practice Address - Zip Code:49047-1704
Practice Address - Country:US
Practice Address - Phone:269-782-2111
Practice Address - Fax:269-782-9852
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704103990363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4272072Medicaid
MI4704103990OtherNURSE PRACTITIONER LICENS
MI4272072Medicaid