Provider Demographics
NPI:1164247334
Name:ADKINS, DEMICKA LASHAY
Entity type:Individual
Prefix:
First Name:DEMICKA
Middle Name:LASHAY
Last Name:ADKINS
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 1:1430 PLAIN AVE NE
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44714-2442
Mailing Address - Country:US
Mailing Address - Phone:330-428-7466
Mailing Address - Fax:
Practice Address - Street 1:1430 PLAIN AVE NE
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44714-2442
Practice Address - Country:US
Practice Address - Phone:330-428-7466
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-21
Last Update Date:2024-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty