Basic Information
| Provider Information | |||||||||
| NPI: | 1205201530 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CAMPOLI | ||||||||
| FirstName: | JENNIFER | ||||||||
| MiddleName: | |||||||||
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| Credential: | APRN, NP-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 230 JASMINE LN | ||||||||
| Address2: | |||||||||
| City: | NEWARK | ||||||||
| State: | DE | ||||||||
| PostalCode: | 197023952 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3028249452 | ||||||||
| FaxNumber: | 3023661700 | ||||||||
| Practice Location | |||||||||
| Address1: | 4701 OGLETOWN STANTON RD | ||||||||
| Address2: | SUITE 3400 | ||||||||
| City: | NEWARK | ||||||||
| State: | DE | ||||||||
| PostalCode: | 197132055 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3023661200 | ||||||||
| FaxNumber: | 3023661700 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/11/2015 | ||||||||
| LastUpdateDate: | 12/11/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | L1-0033691 | DE | N | Nursing Service Providers | Registered Nurse | 363LF0000X | LG-0000889 | DE | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.