Provider Demographics
NPI:1831883750
Name:CAMPBELL, SHERIECE M
Entity type:Individual
Prefix:
First Name:SHERIECE
Middle Name:M
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 NORWOOD AVE PH
Mailing Address - Street 2:
Mailing Address - City:MALVERNE
Mailing Address - State:NY
Mailing Address - Zip Code:11565-1421
Mailing Address - Country:US
Mailing Address - Phone:718-809-9790
Mailing Address - Fax:
Practice Address - Street 1:3512 DANIEL CRES
Practice Address - Street 2:
Practice Address - City:BALDWIN
Practice Address - State:NY
Practice Address - Zip Code:11510-5152
Practice Address - Country:US
Practice Address - Phone:718-809-9790
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-05
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker