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NPI Code Detail

MEDICARE: SCOTTY J CAMPBELL CRNA

MEDICARE: SCOTTY J CAMPBELL CRNA
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
1367500000XCertified Registered Nurse Anesthetist073328NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1396793303
Entity Type Code : Individual
Provider Name (Legal Business Name) : SCOTTY J CAMPBELL CRNA
Provider Business Mailing Address
First Line : PO BOX 601549
Second Line :
City : CHARLOTTE
State : NC
Zip : 28260-1549
Country : US
Telephone Number : 704-384-4239
Fax Number : 704-384-5636
Provider Business Practice Location Address
First Line : 13808 PROFESSIONAL CENTER DR
Second Line :
City : HUNTERSVILLE
State : NC
Zip : 28078-7948
Country : US
Telephone Number : 704-377-4009
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/04/2006
Last Update Date : 10/30/2025

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Directions to “ SCOTTY J CAMPBELL CRNA” Practice Location

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