Healthcare Provider Details

I. General information

NPI: 1922920024
Provider Name (Legal Business Name): EMANUEL LEE CAMPBELL
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2026
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 18TH AVE SE APT 37
MINOT ND
58701-6612
US

IV. Provider business mailing address

400 18TH AVE SE APT 37
MINOT ND
58701-6612
US

V. Phone/Fax

Practice location:
  • Phone: 701-441-1852
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: