MEDICARE: JEANNIE MICHELLE CAMPE NP

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
1	163W00000X	Registered Nurse	R1935776	MN
2	363LF0000X	Family Nurse Practitioner	4838	MN

General Provider Information

NPI Number	:	1114476512
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEANNIE MICHELLE CAMPE NP

Provider Business Mailing Address
First Line	:	5108 W 104TH ST
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55437-2513
Country	:	US
Telephone Number	:	507-317-5556
Fax Number	:

Provider Business Practice Location Address
First Line	:	333 WASHINGTON AVE N
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55401-2263
Country	:	US
Telephone Number	:	612-873-2232
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/26/2016
Last Update Date	:	11/10/2025

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