Provider Demographics
NPI:1831620400
Name:CAMPBELL, STEPHANIE N (DPM)
Entity type:Individual
Prefix:MS
First Name:STEPHANIE
Middle Name:N
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 531968
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78553-1968
Mailing Address - Country:US
Mailing Address - Phone:833-887-4863
Mailing Address - Fax:
Practice Address - Street 1:9901 CALIFORNIA RD
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78521-6135
Practice Address - Country:US
Practice Address - Phone:956-296-1681
Practice Address - Fax:956-296-1680
Is Sole Proprietor?:No
Enumeration Date:2017-03-24
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3180213ES0103X, 213E00000X
NMPOD443213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist