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NPI Code Detail

MEDICARE: CATHERINE J CAMPO

MEDICARE: CATHERINE J CAMPO
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
1104100000XSocial Worker
21041C0700XClinical Social WorkerSW17460FL

General Provider Information

NPI Number : 1073926325
Entity Type Code : Individual
Provider Name (Legal Business Name) : CATHERINE J CAMPO
Provider Business Mailing Address
First Line : 914 HARRISON AVE
Second Line :
City : PANAMA CITY
State : FL
Zip : 32401-2528
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2309 E 15TH ST
Second Line :
City : PANAMA CITY
State : FL
Zip : 32405-6345
Country : US
Telephone Number : 850-747-5272
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/04/2014
Last Update Date : 06/01/2026

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Directions to “ CATHERINE J CAMPO ” Practice Location

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