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General NPI Number Information
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NPI Number | 1023281185
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Entity Type | Individual
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Provider Name | ANIKO VEDETTE CAMPBELL FNP
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Gender | Female
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Dates
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Enumeration Date | 04/10/2008
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Last Update Date | 08/12/2024
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Provider Practice Location Address
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Address Line | 9025 US HIGHWAY 64
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City | LAKELAND
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State | TN
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Zip | 38002-7981
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Country | US
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Telephone | 901-387-2998
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Fax | 901-387-2999
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Provider Business Mailing Address
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Address Line | 9025 US HIGHWAY 64
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City | LAKELAND
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State | TN
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Zip | 38002-7981
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Country | US
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Telephone | 901-387-2998
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Fax | 901-387-2999
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APN13363
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License Number State | TN
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