Scott Campbell
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Nampa, ID
NPI 1639670961 · NPPES record last updated Apr 14, 2018
Key facts
- NPI
- 1639670961
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- 57922 (ID)
- Practice address
- 207 1St St S
Nampa, ID 83651-3703 - Phone
- (208) 466-7869
- Fax
- (208) 466-5359
- NPI assigned
- Feb 22, 2018
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 57922 | ID | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ashwood Recovery LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 57922 | ID | Yes |
Addresses
Primary practice location
207 1St St S
Nampa, ID 83651-3703
Mailing address
211 16TH Ave North
PO Box 9
Nampa, ID 83653-0009
Phone (208) 461-7149
Other practice location 1
207 1st St S
Nampa, ID 83651-3703
Phone (208) 466-7869
Other providers in Nampa, ID
- Jason A Campagnone
- Campanionship Home Care
- Corey K Campbell
- Daniel Campbell
- Lindsay Marie Campbell
- Doreen Canaday
- Robyn Ann Canepa
- Kema Cantu
- Canyon County of Cascadia, LLC
- Canyon Eyecare PLLC
All providers in Nampa, ID · Psychiatric/Mental Health Nurse Practitioner in Idaho
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 14, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.