Provider Demographics
NPI:1235729112
Name:CAMPBELL, MEKAYLA
Entity type:Individual
Prefix:
First Name:MEKAYLA
Middle Name:
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MEKAYLA
Other - Middle Name:
Other - Last Name:PLEASANT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3221 BERMUDA AVE
Mailing Address - Street 2:
Mailing Address - City:SAND SPRINGS
Mailing Address - State:OK
Mailing Address - Zip Code:74063-2902
Mailing Address - Country:US
Mailing Address - Phone:918-271-2324
Mailing Address - Fax:
Practice Address - Street 1:3221 BERMUDA AVE
Practice Address - Street 2:
Practice Address - City:SAND SPRINGS
Practice Address - State:OK
Practice Address - Zip Code:74063-2902
Practice Address - Country:US
Practice Address - Phone:918-271-2324
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-25
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator