Provider Demographics
NPI:1780325787
Name:CAMPBELL, ROBERT (APRN-CNP)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:
Last Name:CAMPBELL
Suffix:
Gender:M
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1222 TROTWOOD AVE STE 601
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:TN
Mailing Address - Zip Code:38401-6410
Mailing Address - Country:US
Mailing Address - Phone:931-840-8547
Mailing Address - Fax:
Practice Address - Street 1:1222 TROTWOOD AVE STE 601
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:TN
Practice Address - Zip Code:38401-6410
Practice Address - Country:US
Practice Address - Phone:931-840-8547
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-05
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN34430363LF0000X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily