Individual provider · NPI-1

Diedre Campbell

Nurse Practitioner, Family · Lithonia, GA

NPI number1154856821
StatusActive
Last updated in NPPESMay 1, 2017

Details

NPI
1154856821
Entity type
Individual (NPI-1)
Name
Diedre Campbell
Sex
Female
Sole proprietor
No
Enumeration date
May 1, 2017
Last updated
May 1, 2017

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LF0000X Nurse Practitioner, FamilyRN195393GAYes

Practice location

6561 Shaffers Way
Lithonia, GA 30058-6427

Phone 404-587-8521

Mailing address

6561 Shaffers Way
Lithonia, GA 30058-6427

Phone 404-587-8521

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