Healthcare Provider Details

I. General information

NPI: 1861089484
Provider Name (Legal Business Name): HALEY CAMPBELL RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/29/2020
Last Update Date: 12/29/2020
Certification Date: 12/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7809 JENSEN AVE
BAKERSFIELD CA
93308-5347
US

IV. Provider business mailing address

7809 JENSEN AVE
BAKERSFIELD CA
93308-5347
US

V. Phone/Fax

Practice location:
  • Phone: 303-517-4555
  • Fax:
Mailing address:
  • Phone: 303-517-4555
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number702472
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: