NPI 1780050419 · live from the CMS NPI Registry
Shannon Campbell, NP
Nurse Practitioner in Jacksonville, FL. National Provider Identifier 1780050419, active.
NPI record
| NPI | 1780050419 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Nurse Practitioner 363L00000X |
| Practice location | 4500 San Pablo Rd S, Jacksonville, FL 32224 |
| Practice phone | 904-953-2000 |
| Enumerated | August 17, 2015 |
| Last updated | August 4, 2021 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner primary | 363L00000X | APRN11013387 (FL) |
| Nurse Practitioner, Family | 363LF0000X | 101.0120646 (VT) |
| Registered Nurse | 163W00000X | 026.0103043 (VT) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.