Provider Demographics
NPI:1841981701
Name:CAMPBELL, WENDY (RN)
Entity type:Individual
Prefix:
First Name:WENDY
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 1:2508 POTOMAC HUNT LN APT 2B
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23233-1519
Mailing Address - Country:US
Mailing Address - Phone:804-605-4314
Mailing Address - Fax:
Practice Address - Street 1:2508 POTOMAC HUNT LN APT 2B
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23233-1519
Practice Address - Country:US
Practice Address - Phone:804-605-4314
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-19
Last Update Date:2023-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001214078163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse