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NPI Code Detail

MEDICARE: MS. THELMA CAMPBELL NURSE

MEDICARE: MS. THELMA CAMPBELL NURSE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered NurseNO 128NJ

General Provider Information

NPI Number : 1003887951
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. THELMA CAMPBELL NURSE
Provider Business Mailing Address
First Line : 12 MEDFORD LN
Second Line :
City : WILLINGBORO
State : NJ
Zip : 08046-3121
Country : US
Telephone Number : 609-835-0155
Fax Number :
Provider Business Practice Location Address
First Line : 5250 NEW JERSEY AVE
Second Line :
City : FORT DIX
State : NJ
Zip : 08640-5017
Country : US
Telephone Number : 609-562-6114
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/30/2006
Last Update Date : 07/08/2007

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