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NPI Code Detail

MEDICARE: MRS. PATRICIA L CAMPBELL CFNP

MEDICARE: MRS. PATRICIA L CAMPBELL CFNP
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
1363LF0000XFamily Nurse PractitionerR856111MS

General Provider Information

NPI Number : 1689920209
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. PATRICIA L CAMPBELL CFNP
Provider Business Mailing Address
First Line : 103 ELKIN CT
Second Line :
City : MACON
State : MS
Zip : 39341-2311
Country : US
Telephone Number : 662-726-9769
Fax Number :
Provider Business Practice Location Address
First Line : 606 N JEFFERSON ST
Second Line :
City : MACON
State : MS
Zip : 39341-2242
Country : US
Telephone Number : 662-726-4264
Fax Number : 662-726-4204
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/01/2012
Last Update Date : 08/23/2012

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