Provider Demographics
NPI:1164548673
Name:CAMPBELL, KRISTIN CARTER (CPNP-)
Entity Type:Individual
Prefix:MRS
First Name:KRISTIN
Middle Name:CARTER
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:CPNP-
Other - Prefix:MS
Other - First Name:KRISTIN
Other - Middle Name:ELIZABETH
Other - Last Name:CARTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:5625 EIGER RD STE 200
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78735-8982
Mailing Address - Country:US
Mailing Address - Phone:512-892-7076
Mailing Address - Fax:855-270-9668
Practice Address - Street 1:12600 HILL COUNTRY BLVD BLDG R-103
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78738-6891
Practice Address - Country:US
Practice Address - Phone:512-358-8180
Practice Address - Fax:855-270-9668
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXRN867225363LP0200X, 363LP0200X
TXAP125831363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics