Healthcare Provider Details

I. General information

NPI: 1790851285
Provider Name (Legal Business Name): KELLYE CAMPBELL ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/27/2006
Last Update Date: 12/12/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4800 SAND POINT WAY NE SEATTLE CHILDREN'S HOSPITAL
SEATTLE WA
98105-3901
US

IV. Provider business mailing address

133 NE 133RD STREET
SEATTLE WA
98125
US

V. Phone/Fax

Practice location:
  • Phone: 206-987-2770
  • Fax: 206-987-2246
Mailing address:
  • Phone: 206-799-5937
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP30006484
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: