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General NPI Number Information
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NPI Number | 1225426299
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Entity Type | Individual
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Provider Name | KEVIN CAMPBELL FNP-BC
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Gender | Male
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Dates
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Enumeration Date | 12/29/2014
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Last Update Date | 07/26/2016
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Provider Practice Location Address
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Address Line | 304 MOUNT MERCY DR
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City | PEWEE VALLEY
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State | KY
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Zip | 40056-8020
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Country | US
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Telephone | 502-241-8611
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Fax | 502-241-4175
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Provider Business Mailing Address
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Address Line | PO BOX 776351
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City | CHICAGO
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State | IL
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Zip | 60677-6351
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Country | US
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Telephone | 502-588-9490
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Fax | 502-272-5116
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 3009043
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License Number State | KY
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