Healthcare Provider Details

I. General information

NPI: 1316801277
Provider Name (Legal Business Name): OLIVER CAMPBELL
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7501 O ST STE 105
LINCOLN NE
68510-2485
US

IV. Provider business mailing address

110 S CANOPY ST STE B313
LINCOLN NE
68508-3839
US

V. Phone/Fax

Practice location:
  • Phone: 402-630-1275
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: