Healthcare Provider Details

I. General information

NPI: 1801133855
Provider Name (Legal Business Name): ANGELA MARIE CAMPBELL ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/10/2013
Last Update Date: 10/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2011 NW 3 AVE
POMPANO BEACH FL
33060-4800
US

IV. Provider business mailing address

1608 SE 3RD AVENUE THIRD FLOOR PBO
FORT LAUDERDALE FL
33316-2564
US

V. Phone/Fax

Practice location:
  • Phone: 954-786-5901
  • Fax: 954-786-0129
Mailing address:
  • Phone: 954-786-5901
  • Fax: 954-786-0129

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberARNP9169480
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: