Provider Demographics
NPI:1558847921
Name:CAMPBELL, QUESSIE (MSN, ARNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:QUESSIE
Middle Name:
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:MSN, ARNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2247 PALM BEACH LAKES BLVD
Mailing Address - Street 2:STE 206
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33409-3413
Mailing Address - Country:US
Mailing Address - Phone:561-502-3821
Mailing Address - Fax:
Practice Address - Street 1:843 SW JASLO AVE
Practice Address - Street 2:
Practice Address - City:PORT SAINT LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34953-5632
Practice Address - Country:US
Practice Address - Phone:561-502-3821
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-18
Last Update Date:2020-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9217837363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0000000000OtherDO NOT HAVE A NUMBER YET