Provider Demographics
NPI:1548560345
Name:CAMPBELL, LORRIE J (LPN)
Entity Type:Individual
Prefix:MISS
First Name:LORRIE
Middle Name:J
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1011 BRITTANY PARK DR
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:TN
Mailing Address - Zip Code:37013-3668
Mailing Address - Country:US
Mailing Address - Phone:615-516-5132
Mailing Address - Fax:
Practice Address - Street 1:1011 BRITTANY PARK DR
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:TN
Practice Address - Zip Code:37013-3668
Practice Address - Country:US
Practice Address - Phone:615-516-5132
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-26
Last Update Date:2010-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN036697164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN036697OtherLICENSE PRACTICAL NURSE