Provider Demographics
NPI:1902155484
Name:CLAUDIA THOMAS CAMPBELL LLC
Entity Type:Organization
Organization Name:CLAUDIA THOMAS CAMPBELL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NP-C, MSN APRN
Authorized Official - Prefix:
Authorized Official - First Name:CLAUDIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:CAMPBELL
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:919-519-1772
Mailing Address - Street 1:3604 SHANNON RD
Mailing Address - Street 2:STE 200
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-6343
Mailing Address - Country:US
Mailing Address - Phone:919-403-2122
Mailing Address - Fax:
Practice Address - Street 1:3604 SHANNON RD
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-6343
Practice Address - Country:US
Practice Address - Phone:919-519-1772
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-30
Last Update Date:2016-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5005907261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center