Provider Demographics
NPI:1366046062
Name:CAMPBELL, JO ANN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JO
Middle Name:ANN
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:709 W COLLEGE ST
Mailing Address - Street 2:
Mailing Address - City:PULASKI
Mailing Address - State:TN
Mailing Address - Zip Code:38478-3614
Mailing Address - Country:US
Mailing Address - Phone:931-363-1132
Mailing Address - Fax:931-363-7165
Practice Address - Street 1:709 W COLLEGE ST
Practice Address - Street 2:
Practice Address - City:PULASKI
Practice Address - State:TN
Practice Address - Zip Code:38478-3614
Practice Address - Country:US
Practice Address - Phone:931-363-1132
Practice Address - Fax:931-363-7165
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-24
Last Update Date:2020-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN32289183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist