Provider Demographics
NPI:1891290789
Name:CAMPBELL, SHERNETT N (FNP-BC)
Entity type:Individual
Prefix:
First Name:SHERNETT
Middle Name:N
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1643 NW 136TH AVE
Mailing Address - Street 2:BLDG: H, SUITE: 100 MSC 11607-0002
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33323-2857
Mailing Address - Country:US
Mailing Address - Phone:954-835-2843
Mailing Address - Fax:
Practice Address - Street 1:114 SANDHILL DR STE 101
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:DE
Practice Address - Zip Code:19709-5805
Practice Address - Country:US
Practice Address - Phone:302-378-4779
Practice Address - Fax:302-378-4789
Is Sole Proprietor?:No
Enumeration Date:2018-03-24
Last Update Date:2024-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELG-0001129363LP2300X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care