Individual
OLIVIA FAITH CAMPBELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2617 DEMARET DR, GULFPORT, MS 39507-2829
(228) 342-1634
Mailing address
2617 DEMARET DR, GULFPORT, MS 39507-2829
(228) 342-1634
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
900931
MS
163WR0006X
Registered Nurse First Assistant
Primary
900931
MS
Other
Enumeration date
08/23/2018
Last updated
08/23/2018
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