Provider Demographics
NPI:1518725845
Name:CAMPBELL, RASHAWN JAMALL
Entity Type:Individual
Prefix:MR
First Name:RASHAWN
Middle Name:JAMALL
Last Name:CAMPBELL
Suffix:
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:RASHAWN
Other - Middle Name:JAMALL
Other - Last Name:CAMPBELL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:2724 HERITAGE AVE NW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44718-3510
Mailing Address - Country:US
Mailing Address - Phone:330-949-0242
Mailing Address - Fax:
Practice Address - Street 1:2724 HERITAGE AVE NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44718-3510
Practice Address - Country:US
Practice Address - Phone:330-949-0242
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-11
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist
No172A00000XOther Service ProvidersDriver