Provider Demographics
NPI:1194811893
Name:BARRETT-CAMPBELL, DANA FAYE (FNP-C)
Entity type:Individual
Prefix:MS
First Name:DANA
Middle Name:FAYE
Last Name:BARRETT-CAMPBELL
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7185 COUNTY ROAD 252
Mailing Address - Street 2:
Mailing Address - City:LIVE OAK
Mailing Address - State:FL
Mailing Address - Zip Code:32060-0868
Mailing Address - Country:US
Mailing Address - Phone:386-963-3008
Mailing Address - Fax:
Practice Address - Street 1:7185 COUNTY ROAD 252
Practice Address - Street 2:
Practice Address - City:LIVE OAK
Practice Address - State:FL
Practice Address - Zip Code:32060-0868
Practice Address - Country:US
Practice Address - Phone:386-963-3008
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2014-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAPO840363LF0000X
FL9229300363LP2300X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL3069222 00Medicaid
FLS83627Medicare UPIN