MEDICARE: ADRIAN DENISE CAMPBELL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171M00000X	Case Manager/Care Coordinator
2	374U00000X	Home Health Aide

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053886051
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADRIAN DENISE CAMPBELL

Provider Business Mailing Address
First Line	:	493 WESTERLY RD
Second Line	:
City	:	AKRON
State	:	OH
Zip	:	44307-2027
Country	:	US
Telephone Number	:	330-256-5097
Fax Number	:	330-400-4051

Provider Business Practice Location Address
First Line	:	493 WESTERLY RD
Second Line	:
City	:	AKRON
State	:	OH
Zip	:	44307-2027
Country	:	US
Telephone Number	:	330-256-5097
Fax Number	:	330-400-4051

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/05/2018
Last Update Date	:	03/23/2022

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Directions to “ ADRIAN DENISE CAMPBELL ” Practice Location

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