Provider Demographics
NPI:1912539867
Name:CAMPBELL, TERRIEANN
Entity Type:Individual
Prefix:
First Name:TERRIEANN
Middle Name:
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 1:3535 MCCORMICK WOODS DR
Mailing Address - Street 2:
Mailing Address - City:OCOEE
Mailing Address - State:FL
Mailing Address - Zip Code:34761-4460
Mailing Address - Country:US
Mailing Address - Phone:407-431-0776
Mailing Address - Fax:
Practice Address - Street 1:3535 MCCORMICK WOODS DR
Practice Address - Street 2:
Practice Address - City:OCOEE
Practice Address - State:FL
Practice Address - Zip Code:34761-4460
Practice Address - Country:US
Practice Address - Phone:407-431-0776
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-09
Last Update Date:2020-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker