Campbell, Jeradine

Campbell, Jeradine is an sole proprietor health care provider with primary practice located at 345 Green St , Monticello FL 32344-2146. She recently has 2 registered licenses in different health care specialties including Nursing Service Related Providers / Nurse's Aide, Other Service Providers / Community Health Worker. Other Service Providers / Community Health Worker is her primary health care specialty. Campbell, Jeradine can be contacted via phone (850) 274-3360.

Contact Information

Primary practice address
345 Green St Monticello FL 32344-2146
Phone: (850) 274-3360
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Related Providers / Nurse's Aide 376K00000X CNA99144 Florida
Other Service Providers / Community Health Worker 172V00000X CNA99144 Florida

Profile Details

NPI number 1730773011
LBN Legal business name Campbell, Jeradine
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 26th, 2021
Last updated Feb 26th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1730773011 NPPES
Florida MEDICAID 105244100

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