Provider Demographics
NPI:1174371595
Name:CAMPBELL, NICOLE ELIZABETH (PA-C)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:ELIZABETH
Last Name:CAMPBELL
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Gender:F
Credentials:PA-C
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Other - First Name:
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Mailing Address - Street 1:1 UNIVERSITY CT
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37210-2739
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:242 INDIAN LAKE BLVD STE 100
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075-6205
Practice Address - Country:US
Practice Address - Phone:615-822-5660
Practice Address - Fax:615-822-5611
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-09
Last Update Date:2025-01-16
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant