MEDICARE: STASHA-GAY KEILIAH CAMPBELL-DRUMMOND PMHNP-BC

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	0024190422	VA

General Provider Information

NPI Number	:	1871336214
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STASHA-GAY KEILIAH CAMPBELL-DRUMMOND PMHNP-BC

Provider Business Mailing Address
First Line	:	308 TURNER RD STE G
Second Line	:
City	:	NORTH CHESTERFIELD
State	:	VA
Zip	:	23225-6428
Country	:	US
Telephone Number	:	804-225-9155
Fax Number	:

Provider Business Practice Location Address
First Line	:	308 TURNER RD STE G
Second Line	:
City	:	NORTH CHESTERFIELD
State	:	VA
Zip	:	23225-6428
Country	:	US
Telephone Number	:	804-225-9144
Fax Number	:

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

Provider Enumeration Date	:	06/14/2024
Last Update Date	:	03/13/2026

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