Provider Demographics
NPI:1275201444
Name:CAMPBELL, KENYA LAKESHIA
Entity Type:Individual
Prefix:MISS
First Name:KENYA
Middle Name:LAKESHIA
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4130 EDISON ST
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45417-1203
Mailing Address - Country:US
Mailing Address - Phone:937-613-2000
Mailing Address - Fax:
Practice Address - Street 1:4130 EDISON ST
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45417-1203
Practice Address - Country:US
Practice Address - Phone:937-613-2000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-02
Last Update Date:2022-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No171W00000XOther Service ProvidersContractor
No251E00000XAgenciesHome Health