Provider Demographics
NPI:1639882061
Name:CAMPBELL, TEAIRA
Entity Type:Individual
Prefix:MRS
First Name:TEAIRA
Middle Name:
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:PO BOX 73
Mailing Address - Street 2:
Mailing Address - City:FORBES ROAD
Mailing Address - State:PA
Mailing Address - Zip Code:15633-0073
Mailing Address - Country:US
Mailing Address - Phone:971-732-9580
Mailing Address - Fax:
Practice Address - Street 1:134 KEAGGY AVE
Practice Address - Street 2:
Practice Address - City:FORBES ROAD
Practice Address - State:PA
Practice Address - Zip Code:15633-0250
Practice Address - Country:US
Practice Address - Phone:971-732-9580
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-30
Last Update Date:2022-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker