Healthcare Provider Details

I. General information

NPI: 1649102211
Provider Name (Legal Business Name): VICKI L CAMPBELL PERINATAL HEALTH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/30/2026
Last Update Date: 05/30/2026
Certification Date: 05/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

313 TEAL LNDG
O FALLON MO
63368-9655
US

IV. Provider business mailing address

313 TEAL LNDG
O FALLON MO
63368-9655
US

V. Phone/Fax

Practice location:
  • Phone: 414-324-2102
  • Fax:
Mailing address:
  • Phone: 414-324-2102
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License NumberVDTA-PHW-2025-C09-03
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: