Provider Demographics
NPI:1205371382
Name:CAMPBELL, DIANNA LEA WILLIAMS (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:DIANNA
Middle Name:LEA WILLIAMS
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:MRS
Other - First Name:DIANNA
Other - Middle Name:
Other - Last Name:CAMPBELL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:10097 BALTIMORE NATIONAL PIKE
Mailing Address - Street 2:WALGREENS #15553
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-3611
Mailing Address - Country:US
Mailing Address - Phone:443-973-3339
Mailing Address - Fax:
Practice Address - Street 1:10097 BALTIMORE NATIONAL PIKE
Practice Address - Street 2:WALGREENS #15553
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21042-3611
Practice Address - Country:US
Practice Address - Phone:443-973-3339
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-29
Last Update Date:2016-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD24582183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist