Healthcare Provider Details

I. General information

NPI: 1154243558
Provider Name (Legal Business Name): NICOLA NATOYA CAMPBELL RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3630 BRONX BLVD
BRONX NY
10467-5402
US

IV. Provider business mailing address

3630 BRONX BLVD
BRONX NY
10467-5402
US

V. Phone/Fax

Practice location:
  • Phone: 929-497-0735
  • Fax:
Mailing address:
  • Phone: 929-497-0735
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WI0500X
TaxonomyInfusion Therapy Registered Nurse
License Number991188
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code163WI0600X
TaxonomyInfection Control Registered Nurse
License Number991188
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code163WW0000X
TaxonomyWound Care Registered Nurse
License Number991188
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code163WX1500X
TaxonomyOstomy Care Registered Nurse
License Number991188
License Number StateNY
# 5
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number991188
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: