Stacy Laura Campbell, PA-C
Physician Assistant in Grand Rapids, MI. Individual provider (NPI-1).
NPI number1720163918
StatusActive
Last updated in NPPESJun 1, 2021
Details
- NPI
- 1720163918
- Entity type
- Individual (NPI-1)
- Name
- Stacy Laura Campbell
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Oct 26, 2006
- Certification date
- Jun 1, 2021
- Last updated
- Jun 1, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 5601005866 | MI | Yes |
Other names
- Stacy Laura Schlumbohm (Former Name)
Practice location
145 Michigan St NeSuite 5500
Grand Rapids, MI 49503-2562
Phone 616-486-5961
Mailing address
100 Michigan St NeMc 845
Grand Rapids, MI 49503-2560
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