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General NPI Number Information
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NPI Number | 1518837152
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Entity Type | Individual
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Provider Name | RAENAH CAMPBELL MS, RDN, LDN
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Gender | Female
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Dates
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Enumeration Date | 11/08/2025
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Last Update Date | 11/08/2025
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Provider Practice Location Address
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Address Line | 14110 PAUL HOWELL RD UNIT 243
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City | NORTHPORT
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State | AL
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Zip | 35475-4695
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Country | US
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Telephone | 315-436-9010
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Fax |
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Provider Business Mailing Address
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Address Line | 14110 PAUL HOWELL RD UNIT 243
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City | NORTHPORT
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State | AL
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Zip | 35475-4695
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Country | US
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Telephone |
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Fax |
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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 | 133VN1501X
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Taxonomy Name | Sports Dietetics Nutrition Registered Dietitian
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License Number | 5734
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License Number State | AL
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