Provider Demographics
NPI:1023281185
Name:CAMPBELL, ANIKO VEDETTE (FNP)
Entity type:Individual
Prefix:MRS
First Name:ANIKO
Middle Name:VEDETTE
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9025 US HIGHWAY 64
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:TN
Mailing Address - Zip Code:38002-7981
Mailing Address - Country:US
Mailing Address - Phone:901-387-2998
Mailing Address - Fax:901-387-2999
Practice Address - Street 1:9025 US HIGHWAY 64
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:TN
Practice Address - Zip Code:38002-7981
Practice Address - Country:US
Practice Address - Phone:901-387-2998
Practice Address - Fax:901-387-2999
Is Sole Proprietor?:No
Enumeration Date:2008-04-10
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN13363363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily