Provider Demographics
NPI:1700499522
Name:CAMPBELL, YOLANDA (FNP)
Entity Type:Individual
Prefix:
First Name:YOLANDA
Middle Name:
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1075 OAKLEAF PLANTATION PKWY
Mailing Address - Street 2:STE 108
Mailing Address - City:ORANGE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32065-3626
Mailing Address - Country:US
Mailing Address - Phone:904-819-5155
Mailing Address - Fax:
Practice Address - Street 1:1075 OAKLEAF PLANTATION PKWY
Practice Address - Street 2:
Practice Address - City:ORANGE PARK
Practice Address - State:FL
Practice Address - Zip Code:32065-3624
Practice Address - Country:US
Practice Address - Phone:904-282-4565
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-31
Last Update Date:2022-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11003763207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine