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General NPI Number Information
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NPI Number | 1477260016
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Entity Type | Individual
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Provider Name | RAHA RAHELAH CAMPBELL NP
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Gender | Female
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Dates
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Enumeration Date | 11/02/2022
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Last Update Date | 10/14/2024
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Provider Practice Location Address
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Address Line | 22700 W 55TH TERRACE
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City | SHAWNEE
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State | KS
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Zip | 66226-6000
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Country | US
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Telephone | 816-347-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 22700 W 55TH TER
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City | SHAWNEE
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State | KS
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Zip | 66226-5602
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Country | US
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Telephone | 913-944-7117
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Fax |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 2022042861
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 5381686052
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License Number State | KS
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