Provider Demographics
NPI:1700117272
Name:CAMPBELL, VERONICA JEAN (RD)
Entity Type:Individual
Prefix:
First Name:VERONICA
Middle Name:JEAN
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 1:2601 N TENAYA WAY
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-0427
Mailing Address - Country:US
Mailing Address - Phone:800-499-2793
Mailing Address - Fax:562-741-4393
Practice Address - Street 1:2601 N TENAYA WAY
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-0427
Practice Address - Country:US
Practice Address - Phone:800-499-2793
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-23
Last Update Date:2010-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered