Healthcare Provider Details

I. General information

NPI: 1902412901
Provider Name (Legal Business Name): OAKLEY CHRISTINE CAMPBELL MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2020
Last Update Date: 09/16/2020
Certification Date: 09/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

GIBAULT CARE, INC 6401 S. US HWY 41
TERRE HAUTE IN
47802-4749
US

IV. Provider business mailing address

GIBAULT CARE, INC 6401 S. US HWY 41
TERRE HAUTE IN
47802-4749
US

V. Phone/Fax

Practice location:
  • Phone: 812-299-1156
  • Fax: 812-298-3109
Mailing address:
  • Phone: 812-299-1156
  • Fax: 812-298-3109

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: