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NPI Code Detail

MEDICARE: LACEY CAMPBELL FNP, NP-C

MEDICARE:   LACEY  CAMPBELL  FNP, NP-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse PractitionerF09200121OK

General Provider Information

NPI Number : 1093322240
Entity Type Code : Individual
Provider Name (Legal Business Name) : LACEY CAMPBELL FNP, NP-C
Provider Business Mailing Address
First Line : 6205 N SANTA FE AVE STE 200
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73118-7536
Country : US
Telephone Number : 405-231-8740
Fax Number : 405-231-8714
Provider Business Practice Location Address
First Line : 6205 N SANTA FE AVE STE 200
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73118-7536
Country : US
Telephone Number : 405-231-8740
Fax Number : 405-231-8714
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/30/2020
Last Update Date : 05/18/2026

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Directions to “ LACEY CAMPBELL FNP, NP-C” Practice Location

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