MEDICARE: DIANE MARIA CAMPBELL DNP,FNP- BC

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
1	363LF0000X	Family Nurse Practitioner	APN0000005980	TN

General Provider Information

NPI Number	:	1679575591
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIANE MARIA CAMPBELL DNP,FNP- BC

Provider Business Mailing Address
First Line	:	3139 LEBANON PIKE
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37214-2314
Country	:	US
Telephone Number	:	615-400-4945
Fax Number	:	615-357-0257

Provider Business Practice Location Address
First Line	:	808 HADLEY AVE
Second Line	:
City	:	OLD HICKORY
State	:	TN
Zip	:	37138-3121
Country	:	US
Telephone Number	:	615-425-4900
Fax Number	:	615-425-4922

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/11/2005
Last Update Date	:	08/04/2019

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