Individual
BEVERLY CAMPBELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2808 S 10TH ST, FORT PIERCE, FL 34982-4306
(772) 672-1555
Mailing address
2808 S 10TH ST, FORT PIERCE, FL 34982-4306
(772) 672-1555
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
—
—
376G00000X
Nursing Home Administrator
Primary
6906322
FL
Other
Enumeration date
04/07/2014
Last updated
07/05/2016
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