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General NPI Number Information
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NPI Number | 1477933976
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Entity Type | Individual
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Provider Name | KEVIN DION CAMPBELL CRNP
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Gender | Male
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Dates
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Enumeration Date | 06/01/2015
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Last Update Date | 02/08/2022
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Provider Practice Location Address
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Address Line | 2828 HIGHWAY 31 S STE 107
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City | DECATUR
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State | AL
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Zip | 35603-1538
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Country | US
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Telephone | 256-351-8870
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Fax | 256-351-0599
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Provider Business Mailing Address
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Address Line | 2828 HIGHWAY 31 S STE 107
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City | DECATUR
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State | AL
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Zip | 35603-1538
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Country | US
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Telephone | 256-351-8870
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Fax | 256-351-0599
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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 | 1-112004
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License Number State | AL
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