Provider Demographics
NPI:1093016545
Name:CAMPBELL, DAWANDA MARIA (LPN)
Entity Type:Individual
Prefix:MRS
First Name:DAWANDA
Middle Name:MARIA
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:895 CLEARFIELD LN
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45240-1256
Mailing Address - Country:US
Mailing Address - Phone:513-742-1263
Mailing Address - Fax:
Practice Address - Street 1:895 CLEARFIELD LN
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45240-1256
Practice Address - Country:US
Practice Address - Phone:513-742-1263
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-14
Last Update Date:2010-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH106727164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse