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Individual

AUDRA V CAMPBELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ARNP

Contact information

Practice address
3991 DUTCHMANS LN STE 303, LOUISVILLE, KY 40207-4723
(502) 891-8300
(502) 891-8338
Mailing address
PO BOX 776879, CHICAGO, IL 60677-6879
(502) 588-9490
(502) 272-5116

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3002535
KY
363L00000X
Nurse Practitioner
3002535
LA
363LP0200X
Pediatric Nurse Practitioner
3002535
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200474820
IN
05
78003969
KY
Enumeration date
01/05/2007
Last updated
04/24/2024
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