Provider Demographics
NPI:1285096362
Name:WHITE-CAMPBELL, SHIRLEY O (APRN)
Entity type:Individual
Prefix:
First Name:SHIRLEY
Middle Name:O
Last Name:WHITE-CAMPBELL
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:229 STATE ROAD 60 E
Mailing Address - Street 2:
Mailing Address - City:LAKE WALES
Mailing Address - State:FL
Mailing Address - Zip Code:33853-3749
Mailing Address - Country:US
Mailing Address - Phone:863-282-6441
Mailing Address - Fax:863-208-9190
Practice Address - Street 1:229 STATE ROAD 60 E
Practice Address - Street 2:
Practice Address - City:LAKE WALES
Practice Address - State:FL
Practice Address - Zip Code:33853-3749
Practice Address - Country:US
Practice Address - Phone:863-282-6441
Practice Address - Fax:863-208-9190
Is Sole Proprietor?:No
Enumeration Date:2016-03-28
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9325964363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily