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NPI Code Detail

MEDICARE: MRS. ALLISON CAMPBELL FNP-BC

MEDICARE: MRS. ALLISON CAMPBELL FNP-BC
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
1363LF0000XFamily Nurse Practitioner19406SC

General Provider Information

NPI Number : 1043695711
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ALLISON CAMPBELL FNP-BC
Provider Business Mailing Address
First Line : 316 BIG SWAMP RD
Second Line :
City : PAMPLICO
State : SC
Zip : 29583-5418
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 137 N ACLINE ST
Second Line :
City : LAKE CITY
State : SC
Zip : 29560-2107
Country : US
Telephone Number : 843-394-8822
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/23/2015
Last Update Date : 07/23/2015

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