Healthcare Provider Details

I. General information

NPI: 1942033683
Provider Name (Legal Business Name): BRITINI NICOLE CAMPBELL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2024
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

84 MARKET RD
BIDWELL OH
45614-9144
US

IV. Provider business mailing address

84 MARKET RD
BIDWELL OH
45614-9144
US

V. Phone/Fax

Practice location:
  • Phone: 740-612-5808
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: