Provider Demographics
NPI:1114720182
Name:CAMPBELL BUTLER, ANNE BARRET (MPH RD LDN)
Entity type:Individual
Prefix:
First Name:ANNE BARRET
Middle Name:
Last Name:CAMPBELL BUTLER
Suffix:
Gender:
Credentials:MPH RD LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 BLYTHE BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28203-5865
Mailing Address - Country:US
Mailing Address - Phone:704-756-5280
Mailing Address - Fax:
Practice Address - Street 1:1001 BLYTHE BLVD STE 200
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28203-5865
Practice Address - Country:US
Practice Address - Phone:704-756-5280
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-27
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL001545133VN1004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1004XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Pediatric