Provider Demographics
NPI:1184927097
Name:CAMPBELL, KERRY-ANN L (FNP)
Entity type:Individual
Prefix:MS
First Name:KERRY-ANN
Middle Name:L
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 PELHAM PARKWAY SOUTH
Mailing Address - Street 2:JACOBI MEDICAL CENTER
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461
Mailing Address - Country:US
Mailing Address - Phone:914-513-9095
Mailing Address - Fax:
Practice Address - Street 1:1400 PELHAM PARKWAY SOUTH
Practice Address - Street 2:JACOBI MEDICAL CENTER
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461
Practice Address - Country:US
Practice Address - Phone:718-918-5700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-15
Last Update Date:2025-07-24
Deactivation Date:2025-06-12
Deactivation Code:
Reactivation Date:2025-07-23
Provider Licenses
StateLicense IDTaxonomies
NY549196163W00000X
NY357074363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse