Kellie Lynn Campbell

Physician Assistant · Provo, UT

Individual Active NPI

NPI number 1053101352

Practice location

1800 Novell Pl
Provo, UT 84606-6171
Phone
(801) 375-5125

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NPI record

NPI
1053101352
Entity type
Individual (Type 1)
Enumeration date
May 9, 2025
Last updated
September 18, 2026
Certified
September 18, 2026
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Physician Assistant Primary 363A00000X 0110012371 VA

About Kellie Campbell

Kellie Lynn Campbell is a healthcare provider registered in the NPI registry with the primary taxonomy Physician Assistant (code 363A00000X). The practice location is 1800 Novell Pl, Provo, UT 84606-6171. The NPI number 1053101352 was assigned on May 9, 2025 and the record was last updated on September 18, 2026.

Kellie Campbell lists a license in the registry: #0110012371 (VA) for Physician Assistant. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Kellie Lynn Campbell?

The NPI number is 1053101352.

What is the phone number of Kellie Campbell?

The phone number listed for the practice location is (801) 375-5125.

Where is Kellie Campbell located?

1800 Novell Pl, Provo, UT 84606-6171.

What is the taxonomy code for Kellie Campbell?

The primary taxonomy code is 363A00000X – Physician Assistant.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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