Individual
AMANDA ANN CAMPBELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
3407 SHAMROCK CT, GAUTIER, MS 39553-6429
(228) 497-0690
(228) 497-1363
Mailing address
3407 SHAMROCK CT, GAUTIER, MS 39553-6429
(228) 497-0690
(228) 497-1363
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
R758293
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00018214
—
MS
Enumeration date
04/14/2010
Last updated
04/14/2010
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