Provider Demographics
NPI:1508889049
Name:CAMPBELL, KAREN D (FNP)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:D
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:D
Other - Last Name:HURD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:23400 US HIGHWAY 160
Mailing Address - Street 2:
Mailing Address - City:WALSENBURG
Mailing Address - State:CO
Mailing Address - Zip Code:81089-8100
Mailing Address - Country:US
Mailing Address - Phone:719-738-4590
Mailing Address - Fax:719-738-4553
Practice Address - Street 1:23400 US HIGHWAY 160
Practice Address - Street 2:
Practice Address - City:WALSENBURG
Practice Address - State:CO
Practice Address - Zip Code:81089-8100
Practice Address - Country:US
Practice Address - Phone:719-738-4590
Practice Address - Fax:719-738-4553
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2020-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0003829-NP363LF0000X
CO62851363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO36235041Medicaid
CO36235041Medicaid
CO36235041Medicaid