Provider Demographics
NPI:1649412628
Name:MEES-CAMPBELL, JESSICA (MD)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:
Last Name:MEES-CAMPBELL
Suffix:
Gender:F
Credentials:MD
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 936
Mailing Address - Street 2:EVMS MEDICAL GROUP
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23501-0936
Mailing Address - Country:US
Mailing Address - Phone:757-446-5888
Mailing Address - Fax:757-466-5918
Practice Address - Street 1:825 FAIRFAX AVE
Practice Address - Street 2:SUITE 710
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23507-1914
Practice Address - Country:US
Practice Address - Phone:757-446-5888
Practice Address - Fax:757-466-5918
Is Sole Proprietor?:No
Enumeration Date:2009-04-06
Last Update Date:2014-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01012535612084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1649412628Medicaid
VAPAROtherVIRGINIA HEALTH NETWORK
VA500783OtherANTHEM
VAPAROtherMULTIPLAN
VA1649412628Medicaid
VAPAROtherCORVEL
VAPAROtherAETNA BEHAVIORAL HEALTH
VA1649412628OtherUNITED BEHAVIORAL HEALTH
VAPAROtherUSA MANAGED CARE
VA1649412628OtherVIRGINIA PREMIER HEALTH PLAN
VAPAROtherCIGNA BEHAVIORAL HEALTH
VAPAROtherMAGELLAN HEALTH SERVICES
VAP01288860Medicare PIN
VAVVA784AMedicare PIN