Healthcare Provider Details

I. General information

NPI: 1326289505
Provider Name (Legal Business Name): FLORENCE L CAMPBELL APN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/17/2009
Last Update Date: 03/17/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 ENGLE ST
ENGLEWOOD NJ
07631-1808
US

IV. Provider business mailing address

350 ENGLE ST
ENGLEWOOD NJ
07631-1808
US

V. Phone/Fax

Practice location:
  • Phone: 201-894-3202
  • Fax: 201-894-1722
Mailing address:
  • Phone: 201-894-3202
  • Fax: 201-894-1722

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number26NJ00129000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: