Provider Demographics
NPI:1902405798
Name:HY, CAMPBELL RAE (FNP)
Entity Type:Individual
Prefix:MRS
First Name:CAMPBELL
Middle Name:RAE
Last Name:HY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 911230
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75391-1230
Mailing Address - Country:US
Mailing Address - Phone:972-997-8000
Mailing Address - Fax:972-234-2987
Practice Address - Street 1:906 W RANDOL MILL RD STE 200
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76012-2510
Practice Address - Country:US
Practice Address - Phone:817-664-4400
Practice Address - Fax:817-664-9605
Is Sole Proprietor?:No
Enumeration Date:2020-10-22
Last Update Date:2021-05-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXAP145445364SX0200X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No364SX0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistOncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX418185102Medicaid