Provider Demographics
NPI:1881070811
Name:CAMPBELL, ANJA (FNP)
Entity type:Individual
Prefix:
First Name:ANJA
Middle Name:
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4170 GOODVIEW RD
Mailing Address - Street 2:
Mailing Address - City:GOODVIEW
Mailing Address - State:VA
Mailing Address - Zip Code:24095-2635
Mailing Address - Country:US
Mailing Address - Phone:540-526-3519
Mailing Address - Fax:
Practice Address - Street 1:150 MARKET RIDGE LN
Practice Address - Street 2:
Practice Address - City:DALEVILLE
Practice Address - State:VA
Practice Address - Zip Code:24083-3258
Practice Address - Country:US
Practice Address - Phone:540-992-4100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-31
Last Update Date:2015-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024172845363LF0000X
VA0001235039163WE0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WE0003XNursing Service ProvidersRegistered NurseEmergency
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily