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Individual
MS. SHANI DEVON CAMPBELL
Active
Individual
MS. SHANI DEVON CAMPBELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT0038
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12115
VA
TN
01
—
33297
TLC FAMILY HEALTHPLAN
TN
05
—
3729568
—
TN
01
—
4078075
BLUE CROSS BLUE SHIELD TN
TN
01
—
P00103288
PALMETTO GAB RR MEDICARE
TN
Enumeration date
06/06/2006
Last updated
06/24/2008
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