Provider Demographics
NPI:1598577579
Name:CAMPBELL, ALEXICIA DARNISHA (BS, HHA)
Entity type:Individual
Prefix:MISS
First Name:ALEXICIA
Middle Name:DARNISHA
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:BS, HHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1855 E WOLFCHASE CIR APT 304
Mailing Address - Street 2:
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38016-2003
Mailing Address - Country:US
Mailing Address - Phone:901-427-9164
Mailing Address - Fax:
Practice Address - Street 1:1855 E WOLFCHASE CIR APT 304
Practice Address - Street 2:
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38016-2003
Practice Address - Country:US
Practice Address - Phone:901-427-9164
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-24
Last Update Date:2025-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171400000X, 171M00000X, 172V00000X, 372600000X
TN20250269P374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No171400000XOther Service ProvidersHealth & Wellness Coach
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No172V00000XOther Service ProvidersCommunity Health Worker
No372600000XNursing Service Related ProvidersAdult Companion