Healthcare Provider Details

I. General information

NPI: 1154289171
Provider Name (Legal Business Name): SHELLY CAMPFIELD APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/10/2026
Last Update Date: 01/10/2026
Certification Date: 01/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3516 E 31ST ST STE B
TULSA OK
74135-1521
US

IV. Provider business mailing address

1029 N CLAY AVE
LIBERAL KS
67901-2510
US

V. Phone/Fax

Practice location:
  • Phone: 785-221-1999
  • Fax:
Mailing address:
  • Phone: 785-221-1999
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number226087
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: