Shana Kay Venesa Campbell

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

F342481 Issued in NY

Practice address

3055 Wilson Ave PH
Bronx, NY 10469-5104

Phone

(347) 882-3069

NPI assigned

Aug 6, 2021

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Shana Kay Witter Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1628208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628208000000",
    "number": "1508530197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3055 WILSON AVE PH",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104695104",
            "telephone_number": "347-882-3069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3055 WILSON AVE PH",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104695104",
            "telephone_number": "347-882-3069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "SHANA KAY",
        "middle_name": "VENESA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-06",
        "last_updated": "2021-08-06",
        "certification_date": "2021-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F342481",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANA KAY",
            "last_name": "WITTER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Patrice Rashawn Campbell, MD
• Rose Campbell
• Ruby Campbell
• Sandra Diana Campbell, RN
• Shakera Campbell
• Sharon Campbell
• Sheree Campbell, RN
• Sidjay Campbell, NP
• Stephanie Campbell
• Tanysha Danielle Campbell, COTA/L

• Family Nurse Practitioner in Bronx, NY
• Providers in Bronx, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.