Provider Demographics
NPI:1053562348
Name:CAMPOS, KIMBERLY KATHRYN
Entity type:Individual
Prefix:MISS
First Name:KIMBERLY
Middle Name:KATHRYN
Last Name:CAMPOS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:517 NE KARAPAT DR
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64155-1329
Mailing Address - Country:US
Mailing Address - Phone:816-309-2026
Mailing Address - Fax:
Practice Address - Street 1:517 NE KARAPAT DR
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64155-1329
Practice Address - Country:US
Practice Address - Phone:816-309-2026
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-05
Last Update Date:2017-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator