Provider Demographics
NPI:1932145638
Name:CAMPBELL, KATHLEEN RENEA (RNFA)
Entity Type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:RENEA
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:645 W COUNTRY ESTATES AVE
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85233-8254
Mailing Address - Country:US
Mailing Address - Phone:480-529-6790
Mailing Address - Fax:480-917-3779
Practice Address - Street 1:645 W COUNTRY ESTATES AVE
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85233-8254
Practice Address - Country:US
Practice Address - Phone:480-529-6790
Practice Address - Fax:480-917-3779
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN107528364SP2800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP2800XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPerioperative