Basic Information
| Provider Information | |||||||||
| NPI: | 1427493295 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | CAMPBELL | ||||||||
| FirstName: | HEATHER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3111 SPRING VALLEY RD | ||||||||
| Address2: | |||||||||
| City: | CHARLOTTE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 282105437 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9194527777 | ||||||||
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| Practice Location | |||||||||
| Address1: | 101 MANNING DRIVE CLB # 7596 | ||||||||
| Address2: | ROOM N4051 N.C. MEMORIAL HOSPITAL | ||||||||
| City: | CHAPEL HILL | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275997596 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9849745063 | ||||||||
| FaxNumber: | 9849747857 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/07/2013 | ||||||||
| LastUpdateDate: | 08/12/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/12/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2080N0001X | 2016-00783 | NC | N | Allopathic & Osteopathic Physicians | Pediatrics | Neonatal-Perinatal Medicine | 208000000X | 2016-00783 | NC | Y | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.