Provider Demographics
NPI:1104453448
Name:MITCHELL-ATKINS, MARION DENISE
Entity type:Individual
Prefix:
First Name:MARION
Middle Name:DENISE
Last Name:MITCHELL-ATKINS
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 1:1005 JUNEAU AVE
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44320-2505
Mailing Address - Country:US
Mailing Address - Phone:330-858-2171
Mailing Address - Fax:
Practice Address - Street 1:1005 JUNEAU AVE
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44320-2505
Practice Address - Country:US
Practice Address - Phone:330-858-2171
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-26
Last Update Date:2020-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0380121Medicaid