Provider Demographics
NPI:1457844482
Name:CAMPTON, CARLEY RENEE (FNP-C)
Entity Type:Individual
Prefix:
First Name:CARLEY
Middle Name:RENEE
Last Name:CAMPTON
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4444 N 32ND ST STE 175
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85018-3999
Mailing Address - Country:US
Mailing Address - Phone:029-520-0002
Mailing Address - Fax:602-224-9119
Practice Address - Street 1:4444 N 32ND ST STE 175
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85018
Practice Address - Country:US
Practice Address - Phone:029-520-0002
Practice Address - Fax:602-224-9119
Is Sole Proprietor?:No
Enumeration Date:2018-06-13
Last Update Date:2019-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP11370363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAP11370OtherARIZONA STATE BOARD OF NURSING
AZF05180196OtherAMERICAN ACADEMY OF NURSE PRACTITIONERS