Healthcare Provider Details

I. General information

NPI: 1740030584
Provider Name (Legal Business Name): AMBER LEE CAMPBELL APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/25/2024
Last Update Date: 05/07/2024
Certification Date: 05/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 2ND ST SE STE 101
HAMPTON IA
50441-2658
US

IV. Provider business mailing address

859 160TH ST
LATIMER IA
50452-7581
US

V. Phone/Fax

Practice location:
  • Phone: 641-812-1094
  • Fax: 641-812-1096
Mailing address:
  • Phone: 641-512-2275
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberA178700
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: