Provider Demographics
NPI:1023430089
Name:CAMPBELL, TERESA (CFA)
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:CFA
Other - Prefix:
Other - First Name:TERESA
Other - Middle Name:
Other - Last Name:GARROD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CFA
Mailing Address - Street 1:1423 JOANNA CT
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:IN
Mailing Address - Zip Code:46123-8011
Mailing Address - Country:US
Mailing Address - Phone:317-371-6697
Mailing Address - Fax:
Practice Address - Street 1:156 AVON MARKET PL
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:IN
Practice Address - Zip Code:46123-6019
Practice Address - Country:US
Practice Address - Phone:317-559-2298
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-10
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
125813246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant