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General NPI Number Information
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NPI Number | 1750980165
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Entity Type | Organization
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Legal Business Name | CAMPBELL KIDS PEDIATRICS; PLLC
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Dates
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Enumeration Date | 10/19/2020
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Last Update Date | 10/19/2020
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Provider Practice Location Address
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Address Line | 7700 LAKEVIEW PKWY STE 300B
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City | ROWLETT
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State | TX
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Zip | 75088-4367
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Country | US
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Telephone | 469-409-3030
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Fax |
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Provider Business Mailing Address
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Address Line | 655 YORK DR
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City | ROCKWALL
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State | TX
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Zip | 75087-7188
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Country | US
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Telephone | 913-235-6585
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Fax |
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Authorized Official
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Title or Position | OWNER, PROVIDER
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Name | ROSE MARIE CAMPBELL
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Credential | APRN, PNP
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Telephone | 496-409-3030
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number |
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License Number State |
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