Provider Demographics
NPI:1154748770
Name:CAMPLESE, DONNA LEE I
Entity type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:LEE
Last Name:CAMPLESE
Suffix:I
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 1:2113 E 43RD ST
Mailing Address - Street 2:
Mailing Address - City:ASHTABULA
Mailing Address - State:OH
Mailing Address - Zip Code:44004-6059
Mailing Address - Country:US
Mailing Address - Phone:440-997-0035
Mailing Address - Fax:
Practice Address - Street 1:2113 E 43RD ST
Practice Address - Street 2:
Practice Address - City:ASHTABULA
Practice Address - State:OH
Practice Address - Zip Code:44004-6059
Practice Address - Country:US
Practice Address - Phone:440-997-0035
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-20
Last Update Date:2014-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0063966Medicaid