# MRS. KIMBERLY ANNE CAMPBELL

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1689940348
- **Gender:** F
- **Credential:** CPNP

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0200X | Pediatric Nurse Practitioner | RN256606 | MA | Yes |

## Other

- **Enumeration date:** 03/28/2012
- **Last updated:** 02/13/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 042297845 | TRICARE | — |
| 05 | — | 110091947A | — | MA |
| 01 | — | 1689940348 | FALLON | — |
| 01 | — | SS0123 | BCBSMA | — |