Provider Demographics
NPI:1558509612
Name:HOSROM CAMPBELL, HANNAH (ARNP)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:
Last Name:HOSROM CAMPBELL
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:HANNAH
Other - Middle Name:
Other - Last Name:HOSROM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:130 MEDICAL CENTER AVE.
Mailing Address - Street 2:
Mailing Address - City:SEBRING
Mailing Address - State:FL
Mailing Address - Zip Code:33870
Mailing Address - Country:US
Mailing Address - Phone:863-385-2606
Mailing Address - Fax:863-382-0184
Practice Address - Street 1:130 MEDICAL CENTER AVE.
Practice Address - Street 2:
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33870
Practice Address - Country:US
Practice Address - Phone:863-385-2606
Practice Address - Fax:863-382-0184
Is Sole Proprietor?:No
Enumeration Date:2009-01-28
Last Update Date:2012-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5004159363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner