Provider Demographics
NPI:1982368361
Name:CAMPBELL, JAIME MICHELL (APRN)
Entity Type:Individual
Prefix:MRS
First Name:JAIME
Middle Name:MICHELL
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 1:1108 CHEROKEE DR
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:AR
Mailing Address - Zip Code:72112-2650
Mailing Address - Country:US
Mailing Address - Phone:870-217-6263
Mailing Address - Fax:
Practice Address - Street 1:302 CORRECTIONS DR
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:AR
Practice Address - Zip Code:72112-8008
Practice Address - Country:US
Practice Address - Phone:870-512-2291
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-22
Last Update Date:2021-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR216637363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily