Provider Demographics
NPI:1447211909
Name:BURKES-CAMPBELL, SANDY K (MS, CCC-A)
Entity type:Individual
Prefix:MRS
First Name:SANDY
Middle Name:K
Last Name:BURKES-CAMPBELL
Suffix:
Gender:F
Credentials:MS, CCC-A
Other - Prefix:MRS
Other - First Name:SANDRA
Other - Middle Name:K
Other - Last Name:BURKES-CAMPBELL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS CCCA
Mailing Address - Street 1:703 THIMBLE SHOALS BLVD., C3
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-2576
Mailing Address - Country:US
Mailing Address - Phone:757-873-8794
Mailing Address - Fax:757-873-5794
Practice Address - Street 1:703 THIMBLE SHOALS BLVD., C-3
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-2576
Practice Address - Country:US
Practice Address - Phone:757-873-8794
Practice Address - Fax:757-873-5794
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2012-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2101000737231H00000X, 237600000X
VA2201000471231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA250276OtherBCBS
VA15482OtherOPTIMA
VA9451315Medicaid
VA250276OtherBCBS
VA15482OtherOPTIMA