Provider Demographics
NPI:1205493103
Name:CAMPBELL, FIONA D (RN)
Entity type:Individual
Prefix:
First Name:FIONA
Middle Name:D
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 1:2412 NW 39TH WAY APT 102
Mailing Address - Street 2:
Mailing Address - City:LAUDERDALE LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33311-1032
Mailing Address - Country:US
Mailing Address - Phone:561-396-8307
Mailing Address - Fax:
Practice Address - Street 1:2412 NW 39TH WAY APT 102
Practice Address - Street 2:
Practice Address - City:LAUDERDALE LAKES
Practice Address - State:FL
Practice Address - Zip Code:33311-1032
Practice Address - Country:US
Practice Address - Phone:561-396-8307
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-26
Last Update Date:2019-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9507201163WH0200X, 163WI0500X, 163WI0600X, 163WR0400X, 163WW0000X, 163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WI0500XNursing Service ProvidersRegistered NurseInfusion Therapy
No163WI0600XNursing Service ProvidersRegistered NurseInfection Control
No163WR0400XNursing Service ProvidersRegistered NurseRehabilitation
No163WW0000XNursing Service ProvidersRegistered NurseWound Care