Provider Demographics
NPI:1083057145
Name:CAMPBELL, PATTI (RN)
Entity Type:Individual
Prefix:MRS
First Name:PATTI
Middle Name:
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 GREENVILLE ST
Mailing Address - Street 2:
Mailing Address - City:ABBEVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29620-1749
Mailing Address - Country:US
Mailing Address - Phone:864-366-5427
Mailing Address - Fax:864-366-8531
Practice Address - Street 1:400 GREENVILLE ST
Practice Address - Street 2:
Practice Address - City:ABBEVILLE
Practice Address - State:SC
Practice Address - Zip Code:29620-1749
Practice Address - Country:US
Practice Address - Phone:864-366-5427
Practice Address - Fax:864-366-8531
Is Sole Proprietor?:No
Enumeration Date:2013-04-09
Last Update Date:2013-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC32741163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse