Provider Demographics
NPI:1154593580
Name:CAMPBELL, SHELLY ANN (RN, ACNP, BC)
Entity type:Individual
Prefix:MS
First Name:SHELLY
Middle Name:ANN
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:RN, ACNP, BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:#1 BARNES JEWISH DRIVE
Mailing Address - Street 2:
Mailing Address - City:ST LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63110
Mailing Address - Country:US
Mailing Address - Phone:314-362-6620
Mailing Address - Fax:314-362-6660
Practice Address - Street 1:#1 BARNES JEWISH
Practice Address - Street 2:
Practice Address - City:ST LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110
Practice Address - Country:US
Practice Address - Phone:314-362-6620
Practice Address - Fax:314-362-6660
Is Sole Proprietor?:No
Enumeration Date:2008-03-26
Last Update Date:2008-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO144962363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care