Individual
MRS. SHANNA LEE CAMPBELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
42121 US HIGHWAY 70, PORTALES, NM 88130-9054
(575) 356-6652
Mailing address
42121 US HIGHWAY 70, PORTALES, NM 88130-9054
(575) 356-6652
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
77810
NM
363LF0000X
Family Nurse Practitioner
77810
NM
Other
Enumeration date
02/07/2024
Last updated
04/28/2026
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