MEDICARE: MRS. SHARON L CAMPBELL ARNP

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
1	363L00000X	Nurse Practitioner	RN121520	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1124182514
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SHARON L CAMPBELL ARNP

Provider Business Mailing Address
First Line	:	10051 5TH STREET NORTH #200
Second Line	:
City	:	ST. PETERSBURG
State	:	FL
Zip	:	33702-2211
Country	:	US
Telephone Number	:	404-755-8996
Fax Number	:	404-755-0570

Provider Business Practice Location Address
First Line	:	1188 RALPH DAVID ABERNATHY BLVD WEST END
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30310-1716
Country	:	US
Telephone Number	:	404-755-0570
Fax Number	:	404-755-0520

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/20/2006
Last Update Date	:	12/13/2016

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