Individual
KIMBERLY JORDAN CAMPBELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1203 IDAHO ST, LEWISTON, ID 83501-1940
(509) 444-8200
Mailing address
611 N IRON BRIDGE WAY, SPOKANE, WA 99202-4932
(509) 444-8888
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M11531
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01-37459
MEDICA
—
01
—
1861669988
REGENCE BLUE SHIELD
ID
01
—
1861669988
BCBS
MN
01
—
1861669988
GROUP HEALTH
—
05
—
1861669988
—
ID
05
—
1861669988
—
MN
01
—
P00767193
MEDICARE RAILROAD
—
Enumeration date
05/08/2008
Last updated
12/02/2024
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