Provider Demographics
NPI:1811351497
Name:CAMPBELL, DENISE (RN)
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 DEERFIELD DR
Mailing Address - Street 2:
Mailing Address - City:PETERSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23805-2507
Mailing Address - Country:US
Mailing Address - Phone:804-691-4765
Mailing Address - Fax:
Practice Address - Street 1:325 DEERFIELD DR
Practice Address - Street 2:
Practice Address - City:PETERSBURG
Practice Address - State:VA
Practice Address - Zip Code:23805-2507
Practice Address - Country:US
Practice Address - Phone:804-691-4765
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-08
Last Update Date:2016-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001209905163W00000X, 163WA2000X, 163WC0400X, 163WC1600X, 163WD0400X, 163WD1100X, 163WH0500X, 163WN0300X, 163WR0400X, 163WS0200X, 163WW0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WA2000XNursing Service ProvidersRegistered NurseAdministrator
No163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163WC1600XNursing Service ProvidersRegistered NurseContinuing Education/Staff Development
No163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator
No163WD1100XNursing Service ProvidersRegistered NurseDialysis, Peritoneal
No163WH0500XNursing Service ProvidersRegistered NurseHemodialysis
No163WN0300XNursing Service ProvidersRegistered NurseNephrology
No163WR0400XNursing Service ProvidersRegistered NurseRehabilitation
No163WS0200XNursing Service ProvidersRegistered NurseSchool
No163WW0000XNursing Service ProvidersRegistered NurseWound Care