Provider Demographics
NPI:1790123594
Name:CAMPBELL, HILDA MARIE
Entity Type:Individual
Prefix:
First Name:HILDA
Middle Name:MARIE
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 1:306 E MAGNOLIA ST
Mailing Address - Street 2:
Mailing Address - City:VILLE PLATTE
Mailing Address - State:LA
Mailing Address - Zip Code:70586-5532
Mailing Address - Country:US
Mailing Address - Phone:337-831-4071
Mailing Address - Fax:337-831-4071
Practice Address - Street 1:306 E MAGNOLIA ST
Practice Address - Street 2:
Practice Address - City:VILLE PLATTE
Practice Address - State:LA
Practice Address - Zip Code:70586-5532
Practice Address - Country:US
Practice Address - Phone:337-831-4071
Practice Address - Fax:337-831-4071
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-13
Last Update Date:2013-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider