Individual
KELLEY C CAMPBELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
701 S HEALTH PKWY, THREE RIVERS, MI 49093-8352
(269) 278-1145
Mailing address
3245 HEALTH DR STE 100, GRANGER, IN 46530-1380
(574) 647-1088
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704278865
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1013468107
—
MI
01
—
MI7819100
MEDICARE PTAN
MI
Enumeration date
10/24/2016
Last updated
03/13/2023
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