Healthcare Provider Details

I. General information

NPI: 1861900391
Provider Name (Legal Business Name): JOANNE E CAMPBELL NURSE PRACTITIONER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JOANNE E FEITEN

II. Dates (important events)

Enumeration Date: 01/18/2018
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3860 DOBIE RD
OKEMOS MI
48864-3704
US

IV. Provider business mailing address

US HIGHWAY 1 STE N107
PALM BEACH GARDENS FL
33408-4518
US

V. Phone/Fax

Practice location:
  • Phone: 517-381-6100
  • Fax:
Mailing address:
  • Phone:
  • Fax: 626-901-3966

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4704242635
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: