Provider Demographics
NPI:1265510226
Name:CAMPBELL, CHRISTIANNA FLEMING (MPT ATC)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTIANNA
Middle Name:FLEMING
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:MPT ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3001 EDWARDS MILL RD
Mailing Address - Street 2:200
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27612-5243
Mailing Address - Country:US
Mailing Address - Phone:919-781-4060
Mailing Address - Fax:919-781-5246
Practice Address - Street 1:3001 EDWARDS MILL RD
Practice Address - Street 2:200
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27612-5243
Practice Address - Country:US
Practice Address - Phone:919-781-4060
Practice Address - Fax:919-781-5246
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2015-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCP8773OtherLICENSE
NCP8773OtherLICENSE