Provider Demographics
NPI:1407553605
Name:CAMPBELL, MURIEL JAMAINE (MS, CNS)
Entity Type:Individual
Prefix:
First Name:MURIEL
Middle Name:JAMAINE
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:MS, CNS
Other - Prefix:
Other - First Name:JAMIE
Other - Middle Name:
Other - Last Name:CAMPBELL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:214 WOODLAND AVE
Mailing Address - Street 2:
Mailing Address - City:SAN RAFAEL
Mailing Address - State:CA
Mailing Address - Zip Code:94901-5046
Mailing Address - Country:US
Mailing Address - Phone:707-623-7756
Mailing Address - Fax:
Practice Address - Street 1:214 WOODLAND AVE
Practice Address - Street 2:
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94901-5046
Practice Address - Country:US
Practice Address - Phone:707-623-7756
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-08
Last Update Date:2023-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist