Healthcare Provider Details

I. General information

NPI: 1538085097
Provider Name (Legal Business Name): JESSICA CAMPBELL CPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/27/2026
Last Update Date: 06/27/2026
Certification Date: 06/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27779 STATE HIGHWAY 38
MARSHFIELD MO
65706-9363
US

IV. Provider business mailing address

27779 STATE HIGHWAY 38
MARSHFIELD MO
65706-9363
US

V. Phone/Fax

Practice location:
  • Phone: 256-452-3869
  • Fax:
Mailing address:
  • Phone: 256-452-3869
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225500000X
TaxonomyRespiratory/Developmental/Rehabilitative Specialist/Technologist
License NumberK3B9J9E7
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: