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NPI Code Detail

MEDICARE: MISS JESSICA ELIZA CAMPBELL ARNP

MEDICARE:  MISS JESSICA ELIZA 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
1363LP0808XPsychiatric/Mental Health Nurse Practitioner181539CT
2363LP0808XPsychiatric/Mental Health Nurse PractitionerARNP9311072FL
3363LF0000XFamily Nurse PractitionerARNP9311072FL
4363LP0808XPsychiatric/Mental Health Nurse Practitioner71381ID

General Provider Information

NPI Number : 1598186801
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS JESSICA ELIZA CAMPBELL ARNP
Provider Business Mailing Address
First Line : 68 SOUTHFIELD AVE STE 100
Second Line :
City : STAMFORD
State : CT
Zip : 06902-7223
Country : US
Telephone Number :
Fax Number : 920-214-1108
Provider Business Practice Location Address
First Line : 4600 TOUCHTON RD E STE 150
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32246-8299
Country : US
Telephone Number : 415-735-5804
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/04/2014
Last Update Date : 01/19/2026

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