Healthcare Provider Details

I. General information

NPI: 1780822866
Provider Name (Legal Business Name): ELEANOR KARANNE CAMPBELL ANP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/28/2009
Last Update Date: 07/24/2025
Certification Date: 07/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2080 E FLAMINGO RD STE 302
LAS VEGAS NV
89119-5180
US

IV. Provider business mailing address

PO BOX 35380
LAS VEGAS NV
89133-5380
US

V. Phone/Fax

Practice location:
  • Phone: 702-657-3873
  • Fax: 702-636-0787
Mailing address:
  • Phone: 702-820-3581
  • Fax: 702-804-3783

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LC1500X
TaxonomyCommunity Health Nurse Practitioner
License NumberAPRN002741
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN002741
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: