Provider Demographics
NPI:1811142391
Name:CAMPBELL, MICHELLE LEA (ARNP)
Entity type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:LEA
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:530 S JACKSON ST
Mailing Address - Street 2:TRAUMA INSTITUTE
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-1675
Mailing Address - Country:US
Mailing Address - Phone:502-562-4060
Mailing Address - Fax:502-562-4197
Practice Address - Street 1:530 S JACKSON ST
Practice Address - Street 2:TRAUMA INSTITUTE
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-1675
Practice Address - Country:US
Practice Address - Phone:502-562-4060
Practice Address - Fax:502-562-4197
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-25
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYP5836363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily