Individual
MINNIE CAMPBELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNA
Contact information
Practice address
617 HIGHWAY 82 W, INDIANOLA, MS 38751-2056
(662) 452-3867
Mailing address
617 HIGHWAY 82 W, INDIANOLA, MS 38751-2056
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
A049132
MS
Other
Enumeration date
06/21/2016
Last updated
06/21/2016
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