Provider Demographics
NPI:1689740763
Name:CAMPBELL, DAWN F (RD, LDN)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:F
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 TOMPSON DR
Mailing Address - Street 2:
Mailing Address - City:SEEKONK
Mailing Address - State:MA
Mailing Address - Zip Code:02771-2803
Mailing Address - Country:US
Mailing Address - Phone:508-761-4314
Mailing Address - Fax:
Practice Address - Street 1:21 TOMPSON DR
Practice Address - Street 2:
Practice Address - City:SEEKONK
Practice Address - State:MA
Practice Address - Zip Code:02771-2803
Practice Address - Country:US
Practice Address - Phone:508-761-4314
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1974133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered