Healthcare Provider Details

I. General information

NPI: 1467360081
Provider Name (Legal Business Name): SONDRESHIA KENYETT CAMPBELL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1810 PAKE AVE
MOBILE AL
36605-4221
US

IV. Provider business mailing address

1810 PAKE AVE
MOBILE AL
36605-4221
US

V. Phone/Fax

Practice location:
  • Phone: 251-408-8352
  • Fax: 251-408-8352
Mailing address:
  • Phone: 251-408-8352
  • Fax: 251-408-8352

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: