Provider Demographics
NPI:1154316941
Name:CAMPBELL, ELAINA L (CPNP, MSN)
Entity Type:Individual
Prefix:MRS
First Name:ELAINA
Middle Name:L
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:CPNP, MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3604 S COOPER ST
Mailing Address - Street 2:SUITE 120
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76015-3481
Mailing Address - Country:US
Mailing Address - Phone:817-466-8008
Mailing Address - Fax:
Practice Address - Street 1:3604 S COOPER ST
Practice Address - Street 2:SUITE 120
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76015-3481
Practice Address - Country:US
Practice Address - Phone:817-466-8008
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-17
Last Update Date:2013-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX726675363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics