Provider Demographics
NPI:1740030584
Name:CAMPBELL, AMBER LEE (APRN)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:LEE
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:859 160TH ST
Mailing Address - Street 2:
Mailing Address - City:LATIMER
Mailing Address - State:IA
Mailing Address - Zip Code:50452-7581
Mailing Address - Country:US
Mailing Address - Phone:641-512-2275
Mailing Address - Fax:
Practice Address - Street 1:700 2ND ST SE STE 101
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:IA
Practice Address - Zip Code:50441-2658
Practice Address - Country:US
Practice Address - Phone:641-812-1094
Practice Address - Fax:641-812-1096
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-25
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA178700363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily