Healthcare Provider Details

I. General information

NPI: 1629954029
Provider Name (Legal Business Name): KANESHA RASHAY DRIVER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2025
Last Update Date: 08/18/2025
Certification Date: 08/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1293 COPLEY RD
AKRON OH
44320-2766
US

IV. Provider business mailing address

794 BARBARA AVE
AKRON OH
44306-3402
US

V. Phone/Fax

Practice location:
  • Phone: 330-374-1199
  • Fax:
Mailing address:
  • Phone: 330-834-7436
  • Fax: 330-834-7436

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberUC631499
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: