Provider Demographics
NPI:1457964611
Name:CAMPBELL, KELSEY MACHELLE (RN, PHN, CSN)
Entity Type:Individual
Prefix:
First Name:KELSEY
Middle Name:MACHELLE
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:RN, PHN, CSN
Other - Prefix:
Other - First Name:KELSEY
Other - Middle Name:MACHELLE
Other - Last Name:HILL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, PHN, CSN
Mailing Address - Street 1:13475 18TH AVE
Mailing Address - Street 2:
Mailing Address - City:LEMOORE
Mailing Address - State:CA
Mailing Address - Zip Code:93245-9436
Mailing Address - Country:US
Mailing Address - Phone:559-836-0058
Mailing Address - Fax:
Practice Address - Street 1:11075 C STREET
Practice Address - Street 2:
Practice Address - City:ARMONA
Practice Address - State:CA
Practice Address - Zip Code:93202
Practice Address - Country:US
Practice Address - Phone:559-583-5020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-27
Last Update Date:2020-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95104059163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool