Provider Demographics
NPI:1548981038
Name:AXSON, ADRIENNE SHATA
Entity type:Individual
Prefix:MRS
First Name:ADRIENNE
Middle Name:SHATA
Last Name:AXSON
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 1:1170 JOY AVE
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44306-2570
Mailing Address - Country:US
Mailing Address - Phone:216-526-4588
Mailing Address - Fax:
Practice Address - Street 1:1170 JOY AVE
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44306-2570
Practice Address - Country:US
Practice Address - Phone:216-526-4588
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-05
Last Update Date:2022-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker