Healthcare Provider Details

I. General information

NPI: 1114476512
Provider Name (Legal Business Name): JEANNIE MICHELLE CAMPE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/26/2016
Last Update Date: 11/10/2025
Certification Date: 11/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 WASHINGTON AVE N
MINNEAPOLIS MN
55401-2263
US

IV. Provider business mailing address

5108 W 104TH ST
MINNEAPOLIS MN
55437-2513
US

V. Phone/Fax

Practice location:
  • Phone: 612-873-2232
  • Fax:
Mailing address:
  • Phone: 507-317-5556
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR1935776
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4838
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: