Provider Demographics
NPI:1477336873
Name:CAMPBELL, CHASTITY ANNETTE (MSN, APRN, FNP-C)
Entity Type:Individual
Prefix:
First Name:CHASTITY
Middle Name:ANNETTE
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7279 SALLIE COLLINS DR
Mailing Address - Street 2:
Mailing Address - City:RUTHER GLEN
Mailing Address - State:VA
Mailing Address - Zip Code:22546-4811
Mailing Address - Country:US
Mailing Address - Phone:540-308-3066
Mailing Address - Fax:
Practice Address - Street 1:4906 RADFORD AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23230-3512
Practice Address - Country:US
Practice Address - Phone:804-354-1996
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-17
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001186247207QA0401X
VA0024188147207QA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine