Basic Information
| Provider Information | |||||||||
| NPI: | 1477260016 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CAMPBELL | ||||||||
| FirstName: | RAHA | ||||||||
| MiddleName: | RAHELAH | ||||||||
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| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 14515 S SHANNAN ST | ||||||||
| Address2: | |||||||||
| City: | OLATHE | ||||||||
| State: | KS | ||||||||
| PostalCode: | 660629779 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9139447117 | ||||||||
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| Practice Location | |||||||||
| Address1: | 100 NE SAINT LUKES BLVD | ||||||||
| Address2: | |||||||||
| City: | LEES SUMMIT | ||||||||
| State: | MO | ||||||||
| PostalCode: | 640866000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8163475000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/02/2022 | ||||||||
| LastUpdateDate: | 11/02/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/12/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 2022042861 | MO | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.