Provider Demographics
NPI:1275873705
Name:CAMPBELL, VICKIE ANN (RN)
Entity Type:Individual
Prefix:MRS
First Name:VICKIE
Middle Name:ANN
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8770 S GARLAND CT
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80128-6996
Mailing Address - Country:US
Mailing Address - Phone:303-904-1331
Mailing Address - Fax:
Practice Address - Street 1:8770 S GARLAND CT
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80128-6996
Practice Address - Country:US
Practice Address - Phone:303-904-1331
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-20
Last Update Date:2013-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO173392163W00000X
CACA 415633163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse