Provider Demographics
NPI:1194081190
Name:CAMPBELL, AMY LOUISE (FNP)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:LOUISE
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:LOUISE
Other - Last Name:COPPINGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1915 WHITE AVE
Mailing Address - Street 2:DEPARTMENT 100
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37916-2300
Mailing Address - Country:US
Mailing Address - Phone:865-541-2865
Mailing Address - Fax:865-541-2564
Practice Address - Street 1:1915 WHITE AVE
Practice Address - Street 2:DEPARTMENT 100
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37916-2300
Practice Address - Country:US
Practice Address - Phone:865-541-2865
Practice Address - Fax:865-541-2564
Is Sole Proprietor?:No
Enumeration Date:2012-04-04
Last Update Date:2015-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN16633363LF0000X
TNRN160244363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily