Provider Demographics
NPI:1437285541
Name:CAMPBELL, RACHELLE SHUNTAE (NP)
Entity Type:Individual
Prefix:MRS
First Name:RACHELLE
Middle Name:SHUNTAE
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5100 ELDORADO PKWY STE 102 PMB 619
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-7295
Mailing Address - Country:US
Mailing Address - Phone:214-729-2064
Mailing Address - Fax:
Practice Address - Street 1:3434 W ILLINOIS AVE STE 306-3
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75211-8709
Practice Address - Country:US
Practice Address - Phone:214-623-1900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-25
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX679911363LF0000X
TXAP155449363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily