Provider Demographics
NPI:1568065951
Name:CAMPBELL, DEBRA K
Entity Type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:K
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 PADUCAH DR
Mailing Address - Street 2:
Mailing Address - City:NEW MARTINSVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:26155-2709
Mailing Address - Country:US
Mailing Address - Phone:304-455-3220
Mailing Address - Fax:304-455-0280
Practice Address - Street 1:145 PADUCAH DR
Practice Address - Street 2:
Practice Address - City:NEW MARTINSVILLE
Practice Address - State:WV
Practice Address - Zip Code:26155-2709
Practice Address - Country:US
Practice Address - Phone:304-455-3220
Practice Address - Fax:304-455-0280
Is Sole Proprietor?:No
Enumeration Date:2020-11-18
Last Update Date:2020-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant