Provider Demographics
NPI:1700066602
Name:CAMPBELL, BECKY LAUREN (RD)
Entity Type:Individual
Prefix:MRS
First Name:BECKY
Middle Name:LAUREN
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4001 ASPEN VIEW CT
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23228-6813
Mailing Address - Country:US
Mailing Address - Phone:540-287-7912
Mailing Address - Fax:
Practice Address - Street 1:3600 W BROAD ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23230-4915
Practice Address - Country:US
Practice Address - Phone:540-287-7912
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-07
Last Update Date:2007-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Metabolic