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Individual

MR. SHANNON LEE CAMPBELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
AGACNP-BC

Contact information

Practice address
102 ARCHER ST, CLYDE, TX 79510-4225
(325) 893-1010
(325) 893-1442
Mailing address
102 ARCHER ST, CLYDE, TX 79510-4225
(325) 893-1010
(325) 893-1442

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
AP135592
TX

Other

Enumeration date
10/23/2017
Last updated
11/15/2022
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