MEDICARE: AARON DESHANE PHINNESSEE

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	3747P1801X	Personal Care Attendant

General Provider Information

NPI Number	:	1144819343
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AARON DESHANE PHINNESSEE

Provider Business Mailing Address
First Line	:	1173 WELTON AVE
Second Line	:
City	:	AKRON
State	:	OH
Zip	:	44306-2834
Country	:	US
Telephone Number	:	330-428-5374
Fax Number	:

Provider Business Practice Location Address
First Line	:	1173 WELTON AVE
Second Line	:
City	:	AKRON
State	:	OH
Zip	:	44306-2834
Country	:	US
Telephone Number	:	330-428-5374
Fax Number	:

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

Provider Enumeration Date	:	01/12/2021
Last Update Date	:	01/12/2021

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Directions to “ AARON DESHANE PHINNESSEE ” Practice Location

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