Healthcare Provider Details

I. General information

NPI: 1922515972
Provider Name (Legal Business Name): JENNIFER LYNN CAMPBELL APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/29/2017
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12200 WARWICK BLVD
NEWPORT NEWS VA
23601-2344
US

IV. Provider business mailing address

12200 WARWICK BLVD STE 110
NEWPORT NEWS VA
23601-2344
US

V. Phone/Fax

Practice location:
  • Phone: 757-534-5100
  • Fax:
Mailing address:
  • Phone: 757-534-5100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number0024182627
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number9218587
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: