Provider Demographics
NPI:1245113331
Name:JILL CAMPBELL
Entity type:Organization
Organization Name:JILL CAMPBELL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:LORRAINE JILL
Authorized Official - Middle Name:PANELO
Authorized Official - Last Name:DE BORJA-CAMPBELL
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:702-219-3922
Mailing Address - Street 1:6604 DITMARS ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89166-8027
Mailing Address - Country:US
Mailing Address - Phone:702-219-3922
Mailing Address - Fax:
Practice Address - Street 1:6604 DITMARS ST
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89166-8027
Practice Address - Country:US
Practice Address - Phone:725-262-0451
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-28
Last Update Date:2025-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty