Provider Demographics
NPI:1336789965
Name:CAMPBELL, ADRIANNE BETH (FNP-BC)
Entity Type:Individual
Prefix:
First Name:ADRIANNE
Middle Name:BETH
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:269 W CREEK DR
Mailing Address - Street 2:
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-3481
Mailing Address - Country:US
Mailing Address - Phone:303-710-0789
Mailing Address - Fax:
Practice Address - Street 1:1216 E MAIN ST STE A
Practice Address - Street 2:
Practice Address - City:LEAGUE CITY
Practice Address - State:TX
Practice Address - Zip Code:77573-7463
Practice Address - Country:US
Practice Address - Phone:281-332-3428
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-11
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX822804163W00000X
TX1007524363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse