Healthcare Provider Details

I. General information

NPI: 1649835265
Provider Name (Legal Business Name): TAMEKA CAMPBELL CPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/08/2019
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

79 DOGWOOD FERRY CT
LAWRENCEVILLE GA
30046-9328
US

IV. Provider business mailing address

PO BOX 491232
LAWRENCEVILLE GA
30049-0021
US

V. Phone/Fax

Practice location:
  • Phone: 678-895-4117
  • Fax:
Mailing address:
  • Phone: 770-904-9173
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code246Y00000X
TaxonomyHealth Information Specialist/Technologist
License Number
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code246Y00000X
TaxonomyHealth Information Specialist/Technologist
License Number
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code171W00000X
TaxonomyContractor
License Number
License Number StateGA
# 6
Primary TaxonomyY
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: