Provider Demographics
NPI:1164700548
Name:CAMPBELL, HEIDI (CD(DONA), MBA, CMR)
Entity Type:Individual
Prefix:
First Name:HEIDI
Middle Name:
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:CD(DONA), MBA, CMR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3343 EASTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28205-2111
Mailing Address - Country:US
Mailing Address - Phone:704-226-5443
Mailing Address - Fax:
Practice Address - Street 1:3343 EASTWOOD DR
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28205-2111
Practice Address - Country:US
Practice Address - Phone:704-226-5443
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-02
Last Update Date:2020-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6938374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC374J00000XOtherDONA INTERNATIONAL