Individual
JACQUELINE CAMPBELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3189 SW FAMBROUGH ST, PORT SAINT LUCIE, FL 34953-4541
(772) 203-3026
Mailing address
3189 SW FAMBROUGH ST, PORT SAINT LUCIE, FL 34953-4541
(772) 203-3026
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
RN 9219448
FL
163W00000X
Registered Nurse
RN 9219448
FL
163WC0400X
Case Management Registered Nurse
RN 9219448
FL
171M00000X
Case Manager/Care Coordinator
Primary
RN 9219448
FL
3747A0650X
Attendant Care Provider
RN 9219448
FL
Other
Enumeration date
02/05/2015
Last updated
02/05/2015
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