Healthcare Provider Details

I. General information

NPI: 1083523757
Provider Name (Legal Business Name): MS. NIYA DAVIS-CAMPBELL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/07/2026
Last Update Date: 09/07/2026
Certification Date: 09/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1014 N ARENDELL AVE
ZEBULON NC
27597-2351
US

IV. Provider business mailing address

7005 SOFTWIND DR
CLAYTON NC
27520-3780
US

V. Phone/Fax

Practice location:
  • Phone: 919-375-4615
  • Fax:
Mailing address:
  • Phone: 919-375-4615
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: