Individual
MRS. KELLY S CAMPBELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP-BC
Contact information
Practice address
36500 AURORA DR, SUMMIT, WI 53066-4899
(262) 434-1000
Mailing address
3301 W FOREST HOME AVE, MILWAUKEE, WI 53215-2843
(414) 389-2377
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4687
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100018593
—
WI
Enumeration date
11/03/2011
Last updated
11/29/2021
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