Provider Demographics
NPI:1487215042
Name:CAMPBELL, VANEITA (CNA)
Entity Type:Individual
Prefix:
First Name:VANEITA
Middle Name:
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3600 S STATE ROAD 7 STE 229
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33023-5289
Mailing Address - Country:US
Mailing Address - Phone:754-260-5986
Mailing Address - Fax:
Practice Address - Street 1:3600 S STATE ROAD 7 STE 229
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33023-5289
Practice Address - Country:US
Practice Address - Phone:754-260-5986
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-25
Last Update Date:2019-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL235926376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376K00000XNursing Service Related ProvidersNurse's AideGroup - Single Specialty