Provider Demographics
NPI:1881867117
Name:CAMPBELL, DOROTHY A (RN)
Entity Type:Individual
Prefix:MS
First Name:DOROTHY
Middle Name:A
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4125 FURMAN FIELD RD
Mailing Address - Street 2:
Mailing Address - City:REMBERT
Mailing Address - State:SC
Mailing Address - Zip Code:29128-9271
Mailing Address - Country:US
Mailing Address - Phone:803-499-2437
Mailing Address - Fax:
Practice Address - Street 1:1850 PINEVIEW DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29209-5085
Practice Address - Country:US
Practice Address - Phone:803-783-0303
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-08
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCR23420163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult