Provider Demographics
NPI:1386504983
Name:CAMPBELL, ADRIENNE LORRAINE (FNP-C)
Entity type:Individual
Prefix:
First Name:ADRIENNE
Middle Name:LORRAINE
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5212 STONY CREEK DR
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48640-3108
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7400 BAY RD
Practice Address - Street 2:
Practice Address - City:UNIVERSITY CENTER
Practice Address - State:MI
Practice Address - Zip Code:48710-0001
Practice Address - Country:US
Practice Address - Phone:989-964-4000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-11-15
Last Update Date:2025-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704330704207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty