Provider Demographics
NPI:1508107921
Name:CAMPAGNARI, WANDA KAYE (RNC,IBCLC)
Entity Type:Individual
Prefix:MRS
First Name:WANDA
Middle Name:KAYE
Last Name:CAMPAGNARI
Suffix:
Gender:F
Credentials:RNC,IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3075 CAITLYNN DR
Mailing Address - Street 2:
Mailing Address - City:SUMTER
Mailing Address - State:SC
Mailing Address - Zip Code:29154-8247
Mailing Address - Country:US
Mailing Address - Phone:843-616-1384
Mailing Address - Fax:
Practice Address - Street 1:3075 CAITLYNN DR
Practice Address - Street 2:
Practice Address - City:SUMTER
Practice Address - State:SC
Practice Address - Zip Code:29154-8247
Practice Address - Country:US
Practice Address - Phone:843-616-1384
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-11
Last Update Date:2013-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC44998163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant