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NPI Code Detail

MEDICARE: JACKLYN LYNNAE CAMPINS CNM

MEDICARE: JACKLYN LYNNAE CAMPINS CNM
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
1367A00000XAdvanced Practice Midwife09000369AIN
2363LW0102XWomen's Health Nurse Practitioner71011036AIN

General Provider Information

NPI Number : 1275127805
Entity Type Code : Individual
Provider Name (Legal Business Name) : JACKLYN LYNNAE CAMPINS CNM
Provider Business Mailing Address
First Line : 250 N SHADELAND AVE
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46219-4959
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 11725 ILLINOIS ST
Second Line :
City : CARMEL
State : IN
Zip : 46032-3008
Country : US
Telephone Number : 317-688-5200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/24/2021
Last Update Date : 03/05/2026

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