Provider Demographics
NPI:1427723048
Name:CAMPBELL, ALEC R (RN)
Entity type:Individual
Prefix:
First Name:ALEC
Middle Name:R
Last Name:CAMPBELL
Suffix:
Gender:M
Credentials:RN
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Mailing Address - Street 1:29500 SOUTHFIELD RD
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48076-2030
Mailing Address - Country:US
Mailing Address - Phone:303-746-2369
Mailing Address - Fax:248-504-5642
Practice Address - Street 1:29500 SOUTHFIELD RD
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48076-2030
Practice Address - Country:US
Practice Address - Phone:248-765-1795
Practice Address - Fax:248-504-5642
Is Sole Proprietor?:No
Enumeration Date:2021-08-16
Last Update Date:2025-09-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4704431615363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health