Provider Demographics
NPI:1780758821
Name:CAMPBELL, THERESA ANNE (BSN)
Entity type:Individual
Prefix:MS
First Name:THERESA
Middle Name:ANNE
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 HYACINTH LN
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28805-9225
Mailing Address - Country:US
Mailing Address - Phone:828-299-3362
Mailing Address - Fax:
Practice Address - Street 1:35 WOODFIN ST
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-3020
Practice Address - Country:US
Practice Address - Phone:828-250-5058
Practice Address - Fax:828-250-6095
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC114136163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool