Provider Demographics
NPI:1679780845
Name:CAMPBELL, JOYCE (FNPC)
Entity type:Individual
Prefix:
First Name:JOYCE
Middle Name:
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:FNPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6531 HIGHWAY 254
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:GA
Mailing Address - Zip Code:30528-6315
Mailing Address - Country:US
Mailing Address - Phone:706-219-1497
Mailing Address - Fax:
Practice Address - Street 1:2023 A GAINESVILLE HIGHWAY SOUTH
Practice Address - Street 2:
Practice Address - City:ALTO
Practice Address - State:GA
Practice Address - Zip Code:30510
Practice Address - Country:US
Practice Address - Phone:706-776-0653
Practice Address - Fax:706-776-4958
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN149456363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily