Provider Demographics
NPI:1841092764
Name:CAMPBELL, JORDYN ASHLEIGH (APRN)
Entity type:Individual
Prefix:
First Name:JORDYN
Middle Name:ASHLEIGH
Last Name:CAMPBELL
Suffix:
Gender:
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:139 LONG LAKE DR
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32550-8243
Mailing Address - Country:US
Mailing Address - Phone:850-259-6051
Mailing Address - Fax:
Practice Address - Street 1:137 CRYSTAL BEACH DR BLDG B
Practice Address - Street 2:
Practice Address - City:DESTIN
Practice Address - State:FL
Practice Address - Zip Code:32541-3569
Practice Address - Country:US
Practice Address - Phone:850-226-7100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-24
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11038079363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health