Provider Demographics
NPI:1558853143
Name:CAMPBELL, JOY M (APRN-AGPCNP-PMHCNP)
Entity Type:Individual
Prefix:
First Name:JOY
Middle Name:M
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:APRN-AGPCNP-PMHCNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:927 BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:IL
Mailing Address - Zip Code:62301-2719
Mailing Address - Country:US
Mailing Address - Phone:217-223-8400
Mailing Address - Fax:217-228-3251
Practice Address - Street 1:927 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:IL
Practice Address - Zip Code:62301-2719
Practice Address - Country:US
Practice Address - Phone:217-223-8400
Practice Address - Fax:217-228-3251
Is Sole Proprietor?:No
Enumeration Date:2018-05-31
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209016530363LG0600X, 363LP0808X
MO2021016496363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology