Healthcare Provider Details

I. General information

NPI: 1780758821
Provider Name (Legal Business Name): THERESA ANNE CAMPBELL BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 WOODFIN ST
ASHEVILLE NC
28801-3020
US

IV. Provider business mailing address

111 HYACINTH LN
ASHEVILLE NC
28805-9225
US

V. Phone/Fax

Practice location:
  • Phone: 828-250-5058
  • Fax: 828-250-6095
Mailing address:
  • Phone: 828-299-3362
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number114136
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: