Individual
MS. COTY L CAMPBELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
1600 LAKE MURRAY BLVD, COLUMBIA, SC 29212-8623
(803) 731-9600
(803) 731-0297
Mailing address
1600 LAKE MURRAY BLVD, COLUMBIA, SC 29212-8623
(803) 731-9600
(803) 731-0297
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1694
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P604057400
MEDICARE PTAN
SC
Enumeration date
01/31/2007
Last updated
03/17/2018
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