Provider Demographics
NPI:1184125619
Name:CAMPBELL, HILLARY (STNA)
Entity type:Individual
Prefix:
First Name:HILLARY
Middle Name:
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:STNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:951 FERNDALE AVE
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45406-5112
Mailing Address - Country:US
Mailing Address - Phone:937-830-7474
Mailing Address - Fax:
Practice Address - Street 1:6016 COTILLION CT
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:OH
Practice Address - Zip Code:45315-8701
Practice Address - Country:US
Practice Address - Phone:937-789-1487
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-21
Last Update Date:2023-11-14
Deactivation Date:2023-08-23
Deactivation Code:
Reactivation Date:2023-11-14
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health