Provider Demographics
NPI:1679962765
Name:CAMPBELL, BRIANNA (NP)
Entity Type:Individual
Prefix:
First Name:BRIANNA
Middle Name:
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6799 GREAT OAKS RD
Mailing Address - Street 2:SUITE 250
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38138-2588
Mailing Address - Country:US
Mailing Address - Phone:901-821-8300
Mailing Address - Fax:901-259-9793
Practice Address - Street 1:6799 GREAT OAKS RD
Practice Address - Street 2:SUITE 250
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38138-2588
Practice Address - Country:US
Practice Address - Phone:901-821-8300
Practice Address - Fax:901-259-9793
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-13
Last Update Date:2015-01-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN19565363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner