Healthcare Provider Details

I. General information

NPI: 1326960907
Provider Name (Legal Business Name): JASAI BRIANNA CAMPBELL RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 BROOKDALE PLZ
BROOKLYN NY
11212-3139
US

IV. Provider business mailing address

22506 138TH AVE
LAURELTON NY
11413-2418
US

V. Phone/Fax

Practice location:
  • Phone: 718-240-5000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License Number911853
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: