Provider Demographics
NPI:1093918096
Name:CAMPBELL, DEANNA DAWN (FNP)
Entity type:Individual
Prefix:MRS
First Name:DEANNA
Middle Name:DAWN
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2790 CLAY EDWARDS DR STE 410
Mailing Address - Street 2:
Mailing Address - City:NORTH KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64116-3274
Mailing Address - Country:US
Mailing Address - Phone:816-474-0458
Mailing Address - Fax:816-471-2723
Practice Address - Street 1:1295 E 151ST ST STE 7
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062-3429
Practice Address - Country:US
Practice Address - Phone:913-381-0622
Practice Address - Fax:913-254-1120
Is Sole Proprietor?:No
Enumeration Date:2007-06-07
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2004021048363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOX93000014Medicare UPIN