Individual
STACI KATHERINE CAMPBELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
170 COLSON DR, RUSSELL SPRINGS, KY 42642-4587
(850) 558-1818
Mailing address
170 COLSON DR, RUSSELL SPRINGS, KY 42642-4587
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
1173119
KY
164W00000X
Licensed Practical Nurse
2034684
KY
Other
Enumeration date
12/29/2014
Last updated
08/27/2022
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