Provider Demographics
NPI:1821701699
Name:CAMPBELL-GILPIN, DAVIA ANDREA (NP)
Entity Type:Individual
Prefix:MRS
First Name:DAVIA
Middle Name:ANDREA
Last Name:CAMPBELL-GILPIN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1039 NW 125TH TER
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33323-3187
Mailing Address - Country:US
Mailing Address - Phone:954-696-2547
Mailing Address - Fax:
Practice Address - Street 1:1039 NW 125TH TER
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33323-3187
Practice Address - Country:US
Practice Address - Phone:954-696-2547
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-27
Last Update Date:2022-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11023558363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health