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Individual

VICTORIA LYNN CAMPBELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RDN

Contact information

Practice address
117 COVENTRY LN, CANTON, MS 39046-6610
(662) 212-2219
Mailing address
117 COVENTRY LN, CANTON, MS 39046-6610
(662) 212-2219

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
D1688
MS
133VN1004X
Pediatric Nutrition Registered Dietitian
DT82188
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
149984001
TX
05
207164901
TX
Enumeration date
05/31/2012
Last updated
08/05/2021
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