Healthcare Provider Details

I. General information

NPI: 1467066985
Provider Name (Legal Business Name): ROWANTY JENKINS CAMPBELL FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2020
Last Update Date: 04/24/2025
Certification Date: 04/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6316 OLD OAK RIDGE RD STE E
GREENSBORO NC
27410-9940
US

IV. Provider business mailing address

PO BOX 60447
CHARLOTTE NC
28260-0447
US

V. Phone/Fax

Practice location:
  • Phone: 336-605-1337
  • Fax: 336-605-3776
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number5013754
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: