Provider Demographics
NPI:1508308685
Name:CAMPOS, STEPHANIE JEAN (DNP, WHNP)
Entity Type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:JEAN
Last Name:CAMPOS
Suffix:
Gender:F
Credentials:DNP, WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 3RD ST W
Mailing Address - Street 2:
Mailing Address - City:RANDOLPH AFB
Mailing Address - State:TX
Mailing Address - Zip Code:78150-4800
Mailing Address - Country:US
Mailing Address - Phone:210-652-1836
Mailing Address - Fax:
Practice Address - Street 1:PSC 76
Practice Address - Street 2:39 HCOS
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09824
Practice Address - Country:US
Practice Address - Phone:322-316-3380
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-07
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX730182163WM0102X
AZAP9629363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No163WM0102XNursing Service ProvidersRegistered NurseMaternal Newborn