Healthcare Provider Details

I. General information

NPI: 1205846847
Provider Name (Legal Business Name): SHERRI G CAMPBELL CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2006
Last Update Date: 06/06/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

561 W. CENTRAL AVENUE
DELAWARE OH
43015
US

IV. Provider business mailing address

5400 FRANTZ RD STE 250
DUBLIN OH
43016-6102
US

V. Phone/Fax

Practice location:
  • Phone: 740-615-1324
  • Fax: 740-615-1344
Mailing address:
  • Phone: 740-615-1324
  • Fax: 740-615-1344

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberNA-08709
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberCOA.08709.NA
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: