Individual
KIRSTEN RASHAE CAMPBELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
705 RILEY HOSPITAL DR, INDIANAPOLIS, IN 46202-5109
(317) 948-8016
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28236336A
IN
363L00000X
Nurse Practitioner
71011020A
IN
363LP0200X
Pediatric Nurse Practitioner
Primary
71011020A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001629068
ANTHEM PTAN
IN
01
—
1102279996
ANTHEM PTAN
IN
05
—
300050072
—
IN
05
—
300050076
—
IN
Enumeration date
08/22/2019
Last updated
02/10/2025
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