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NPI Code Detail

MEDICARE: LATRERA CAMPBELL WOODBERRY FNP

MEDICARE: LATRERA CAMPBELL WOODBERRY FNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerSP028969PA
2363LF0000XFamily Nurse Practitioner11017086FL
3363LF0000XFamily Nurse Practitioner0024186647VA
4363LF0000XFamily Nurse PractitionerAC005136MD
5363LF0000XFamily Nurse Practitioner5015386NC
6363LF0000XFamily Nurse Practitioner092349-23NH
7363LF0000XFamily Nurse Practitioner22659SC
8363LF0000XFamily Nurse Practitioner95037116CA
9363LF0000XFamily Nurse PractitionerGAA-NP001009GA
10363LF0000XFamily Nurse Practitioner26NJ14862800NJ

General Provider Information

NPI Number : 1679037444
Entity Type Code : Individual
Provider Name (Legal Business Name) : LATRERA CAMPBELL WOODBERRY FNP
Provider Business Mailing Address
First Line : 2518 HIGHWAY 9 E
Second Line :
City : DILLON
State : SC
Zip : 29536-6166
Country : US
Telephone Number : 843-841-5313
Fax Number :
Provider Business Practice Location Address
First Line : 333 1ST ST STE A
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94105-2661
Country : US
Telephone Number : 888-803-3370
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/25/2019
Last Update Date : 06/02/2026

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