Provider Demographics
NPI:1780223917
Name:CAMPBELL, LENISHA NICOLE (MSN, PMHNP)
Entity type:Individual
Prefix:MRS
First Name:LENISHA
Middle Name:NICOLE
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:MSN, PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20113 AZUL MARBLE LOOP
Mailing Address - Street 2:
Mailing Address - City:LAND O LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:34638-3240
Mailing Address - Country:US
Mailing Address - Phone:314-605-4922
Mailing Address - Fax:
Practice Address - Street 1:5825 ARGERIAN DR STE 101
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33545-4140
Practice Address - Country:US
Practice Address - Phone:239-690-6906
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-06
Last Update Date:2024-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11013453363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health