Provider Demographics
NPI:1568759876
Name:CAMPBELL, CAROL D (DNP, APRN, PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:D
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:DNP, APRN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 682
Mailing Address - Street 2:
Mailing Address - City:SHERIDAN
Mailing Address - State:AR
Mailing Address - Zip Code:72150-0682
Mailing Address - Country:US
Mailing Address - Phone:870-942-5610
Mailing Address - Fax:
Practice Address - Street 1:211 W HIGH ST
Practice Address - Street 2:
Practice Address - City:SHERIDAN
Practice Address - State:AR
Practice Address - Zip Code:72150-2118
Practice Address - Country:US
Practice Address - Phone:870-942-5610
Practice Address - Fax:870-942-2672
Is Sole Proprietor?:No
Enumeration Date:2011-07-07
Last Update Date:2017-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARSO1114364SP0809X
ARA003778363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult