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General NPI Number Information
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NPI Number | 1528613841
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Entity Type | Individual
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Provider Name | BRIANNA ELOISE CAMPOS APN-CRNA
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Gender | Female
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Dates
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Enumeration Date | 08/04/2019
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Last Update Date | 04/02/2026
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Provider Practice Location Address
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Address Line | 5145 N CALIFORNIA AVE
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City | CHICAGO
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State | IL
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Zip | 60625-3661
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Country | US
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Telephone | 773-293-5486
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Fax | 773-989-1639
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Provider Business Mailing Address
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Address Line | 2650 RIDGE AVE STE 1223
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City | EVANSTON
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State | IL
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Zip | 60201-1700
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Country | US
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Telephone | 847-570-2040
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Fax | 847-733-5315
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 041.413285
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 28252941A
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 209020269
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License Number State | IL
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