Provider Demographics
NPI:1043262975
Name:CAMPBELL, SUZANNE E (ARNP-C)
Entity Type:Individual
Prefix:MRS
First Name:SUZANNE
Middle Name:E
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:ARNP-C
Other - Prefix:MS
Other - First Name:SUZANNE
Other - Middle Name:
Other - Last Name:ADLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP-C
Mailing Address - Street 1:118 SEVEN HILLS DR
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34609
Mailing Address - Country:US
Mailing Address - Phone:352-666-6950
Mailing Address - Fax:352-666-6438
Practice Address - Street 1:118 SEVEN HILLS DR
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34609
Practice Address - Country:US
Practice Address - Phone:352-666-6950
Practice Address - Fax:352-666-6438
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2019-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN2520192363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL304751200Medicaid
FLY004AOtherBLUE CROSS BLUE SHIELD
FLE8319KMedicare PIN
FL304751200Medicaid
FLP70773Medicare UPIN
FLE8319BMedicare ID - Type Unspecified