Provider Demographics
NPI:1346385945
Name:CAMPBELL, MARCELLA MEADOWS (FNPC MSN)
Entity Type:Individual
Prefix:MRS
First Name:MARCELLA
Middle Name:MEADOWS
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:FNPC MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 WILLIAM R HARVEY WAY
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23669-4750
Mailing Address - Country:US
Mailing Address - Phone:757-727-5316
Mailing Address - Fax:757-728-6612
Practice Address - Street 1:132 WILLIAM R HARVEY WAY
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23669-4750
Practice Address - Country:US
Practice Address - Phone:757-727-5316
Practice Address - Fax:757-728-6612
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2019-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP9894363L00000X
VA0024170161363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA009308150OtherMEDICAL DEPT OF HEALTH SE
CAWNP9894AOtherPPIN MEDICARE