Basic Information
| Provider Information | |||||||||
| NPI: | 1023787082 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CAMPBELL | ||||||||
| FirstName: | ADAM | ||||||||
| MiddleName: | CHRISTOPHER | ||||||||
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| Credential: | FNP-BC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 213 RIDGECREST DR | ||||||||
| Address2: | |||||||||
| City: | EASLEY | ||||||||
| State: | SC | ||||||||
| PostalCode: | 296409652 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8643600217 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 10630 CLEMSON BLVD STE 100 | ||||||||
| Address2: | |||||||||
| City: | SENECA | ||||||||
| State: | SC | ||||||||
| PostalCode: | 296784545 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8644826000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/12/2021 | ||||||||
| LastUpdateDate: | 11/10/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/10/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 25383 | SC | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.