NPI Code Details Logo

NPI 1366002628

NPI 1366002628 : CURTIS RAY CAMPBELL CRNA : WINSTON SALEM, NC

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1366002628
-----------------------------------------------------
    Entity Type          |    Individual 
-----------------------------------------------------
    Provider Name        |    CURTIS RAY CAMPBELL CRNA
-----------------------------------------------------
    Gender               |    Male 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    06/19/2019
-----------------------------------------------------
    Last Update Date     |    10/06/2025
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    MEDICAL CENTER BLVD 
-----------------------------------------------------
    City                 |    WINSTON SALEM
-----------------------------------------------------
    State                |    NC
-----------------------------------------------------
    Zip                  |    27157-0001
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    336-716-9252
-----------------------------------------------------
    Fax                  |    336-716-0567
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    100 KIMEL FOREST DR 
-----------------------------------------------------
    City                 |    WINSTON SALEM
-----------------------------------------------------
    State                |    NC
-----------------------------------------------------
    Zip                  |    27103-6074
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    336-713-0947
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    
-----------------------------------------------------
    Name                 |        
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    367500000X
-----------------------------------------------------
    Taxonomy Name        |    Certified Registered Nurse Anesthetist
-----------------------------------------------------
    License Number       |    6132
-----------------------------------------------------
    License Number State |    NC
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
    Taxonomy Code        |    367500000X
-----------------------------------------------------
    Taxonomy Name        |    Certified Registered Nurse Anesthetist
-----------------------------------------------------
    License Number       |    208893
-----------------------------------------------------
    License Number State |    NC
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.