Provider Demographics
NPI:1588556310
Name:CAMPBELL, TEAIRA L
Entity type:Individual
Prefix:
First Name:TEAIRA
Middle Name:L
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4906 BANBURY CT APT 9
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44128-5348
Mailing Address - Country:US
Mailing Address - Phone:216-804-3195
Mailing Address - Fax:
Practice Address - Street 1:4906 BANBURY CT APT 9
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44128-5348
Practice Address - Country:US
Practice Address - Phone:216-804-3195
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-16
Last Update Date:2025-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider