Individual
MAXINE HELEN CAMPBELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5971 SUITE C NEW JESUP HWY, BRUNSWICK, GA 31525-1627
(912) 242-1130
(912) 342-8177
Mailing address
5971 SUITE C NEW JESUP HWY, BRUNSWICK, GA 31525-1627
(912) 242-1130
(912) 342-8177
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
063-R-1722
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1811371065
HHA
GA
Enumeration date
01/17/2017
Last updated
02/17/2017
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