Provider Demographics
NPI:1720885585
Name:CAMPBELL, WINONA
Entity type:Individual
Prefix:MS
First Name:WINONA
Middle Name:
Last Name:CAMPBELL
Suffix:
Gender:
Credentials:
Other - Prefix:MS
Other - First Name:WINONA
Other - Middle Name:
Other - Last Name:CAMPBELL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:HOLMWOOD ADULT AND SENIOR SERVICES
Mailing Address - Street 2:769 CENTRE ST #217
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02130
Mailing Address - Country:US
Mailing Address - Phone:617-866-1963
Mailing Address - Fax:
Practice Address - Street 1:HOLMWOOD ADULT AND SENIOR SERVICES
Practice Address - Street 2:769 CENTRE ST #217
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02130
Practice Address - Country:US
Practice Address - Phone:617-866-1963
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-28
Last Update Date:2025-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2331335163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health