Provider Demographics
NPI:1639455819
Name:CAMPBELL, GERLYN (APRN)
Entity Type:Individual
Prefix:MS
First Name:GERLYN
Middle Name:
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15544 W COLONIAL DR
Mailing Address - Street 2:
Mailing Address - City:WINTER GARDEN
Mailing Address - State:FL
Mailing Address - Zip Code:34787-9556
Mailing Address - Country:US
Mailing Address - Phone:352-504-0340
Mailing Address - Fax:800-443-6422
Practice Address - Street 1:118 W ORANGE ST
Practice Address - Street 2:
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32714-2537
Practice Address - Country:US
Practice Address - Phone:800-457-4573
Practice Address - Fax:800-443-6422
Is Sole Proprietor?:No
Enumeration Date:2011-11-01
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9474992363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health