Provider Demographics
NPI:1508957077
Name:CAMPBELL, ROSEMARY VIOLA (MPA, RD)
Entity type:Individual
Prefix:MRS
First Name:ROSEMARY
Middle Name:VIOLA
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:MPA, RD
Other - Prefix:MRS
Other - First Name:ROSEMARY
Other - Middle Name:VIOLA
Other - Last Name:CAMPBELL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RDN
Mailing Address - Street 1:116 N PAULINE ST
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38104-1005
Mailing Address - Country:US
Mailing Address - Phone:901-523-8990
Mailing Address - Fax:
Practice Address - Street 1:116 N PAULINE ST
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38104-1005
Practice Address - Country:US
Practice Address - Phone:901-523-8990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2025-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
840107133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered