Provider Demographics
NPI:1588239347
Name:CAMPBELL, REBECCA LYNNE (FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:LYNNE
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:LYNNE
Other - Last Name:HALLAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-BC
Mailing Address - Street 1:10383 HAGEN RANCH RD STE 100
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33437-3782
Mailing Address - Country:US
Mailing Address - Phone:561-349-7653
Mailing Address - Fax:561-739-5255
Practice Address - Street 1:10383 HAGEN RANCH RD STE 100
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33437-3782
Practice Address - Country:US
Practice Address - Phone:561-349-7653
Practice Address - Fax:561-739-5255
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-24
Last Update Date:2021-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11013877363LF0000X
FL9464135163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse