Provider Demographics
NPI:1740653583
Name:CAMPBELL-JULIEN, SHERYL ANTOINETTE (PMHNP)
Entity type:Individual
Prefix:MRS
First Name:SHERYL
Middle Name:ANTOINETTE
Last Name:CAMPBELL-JULIEN
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:MRS
Other - First Name:SHERYL
Other - Middle Name:ANTOINETTE
Other - Last Name:BOAKYE-YIADOM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN, RN
Mailing Address - Street 1:206 S ELMWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14201-2398
Mailing Address - Country:US
Mailing Address - Phone:716-541-0650
Mailing Address - Fax:
Practice Address - Street 1:206 S ELMWOOD AVE
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14201-2398
Practice Address - Country:US
Practice Address - Phone:716-541-0650
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-02
Last Update Date:2015-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF401931-1363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health