Healthcare Provider Details

I. General information

NPI: 1407007602
Provider Name (Legal Business Name): KIMBERLY A CAMPBELL ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2008
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3937 W 69TH TER STE A
PRAIRIE VILLAGE KS
66208-2602
US

IV. Provider business mailing address

2300 RED BRIDGE TER
KANSAS CITY MO
64131-3634
US

V. Phone/Fax

Practice location:
  • Phone: 913-585-8995
  • Fax:
Mailing address:
  • Phone: 816-804-1554
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number107782
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: