MEDICARE: MS. SARAH LYNN 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
1	367500000X	Certified Registered Nurse Anesthetist	0024195808	VA
2	367500000X	Certified Registered Nurse Anesthetist	GAA-CRNA003256	GA
3	367500000X	Certified Registered Nurse Anesthetist	APRN11032882	FL

General Provider Information

NPI Number	:	1467218917
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SARAH LYNN CAMPBELL CRNA

Provider Business Mailing Address
First Line	:	2155 MORGAN WIELAND LN APT 104
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33813-3184
Country	:	US
Telephone Number	:	919-747-1633
Fax Number	:	919-747-1633

Provider Business Practice Location Address
First Line	:	2904 W BAY TO BAY BLVD
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33629-8113
Country	:	US
Telephone Number	:	813-434-0380
Fax Number	:

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

Provider Enumeration Date	:	02/22/2024
Last Update Date	:	12/22/2025

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