=====================================================
General NPI Number Information
=====================================================
NPI Number | 1154289171
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SHELLY CAMPFIELD APRN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/10/2026
-----------------------------------------------------
Last Update Date | 01/10/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3516 E 31ST ST STE B
-----------------------------------------------------
City | TULSA
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 74135-1521
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 785-221-1999
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1029 N CLAY AVE
-----------------------------------------------------
City | LIBERAL
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 67901-2510
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 785-221-1999
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2084P0804X
-----------------------------------------------------
Taxonomy Name | Child & Adolescent Psychiatry Physician
-----------------------------------------------------
License Number | 226087
-----------------------------------------------------
License Number State | OK
-----------------------------------------------------