Provider Demographics
NPI:1245475409
Name:WHITE CAMPBELL, ROSEALEE
Entity type:Individual
Prefix:MRS
First Name:ROSEALEE
Middle Name:
Last Name:WHITE CAMPBELL
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:ROSEALEE
Other - Middle Name:
Other - Last Name:WHITE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3026 INDIANA AVE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37209-3809
Mailing Address - Country:US
Mailing Address - Phone:615-340-0824
Mailing Address - Fax:
Practice Address - Street 1:3026 INDIANA AVE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37209-3809
Practice Address - Country:US
Practice Address - Phone:615-340-0824
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-02
Last Update Date:2008-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No372600000XNursing Service Related ProvidersAdult Companion