Healthcare Provider Details

I. General information

NPI: 1477336873
Provider Name (Legal Business Name): CHASTITY ANNETTE CAMPBELL MSN, APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2023
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11600 BUSY ST
NORTH CHESTERFIELD VA
23236-4066
US

IV. Provider business mailing address

7279 SALLIE COLLINS DR
RUTHER GLEN VA
22546-4811
US

V. Phone/Fax

Practice location:
  • Phone: 804-506-0526
  • Fax:
Mailing address:
  • Phone: 540-308-3066
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number0001186247
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number0024188147
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: