MARY CANONICO PMHNP-BC NPI 1811465594

NPI Information

NPI: 1811465594
Provider Name: MARY CANONICO, PMHNP-BC
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Individual

Specialization: Psychiatric/Mental Health

PECOS Registration: Yes

Address:
202 E BAGLEY RD
BEREA, OH
ZIP 44017
Phone: (216) 296-6845
Get Directions

Mary Canonico, PMHNP-BC is a psychiatric/mental health nurse practitioner in Berea, OH. Mary Canonico, PMHNP-BC NPI is 1811465594. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

202 E BAGLEY RD
BEREA, OH
ZIP 44017-058
Phone: (216) 296-6845

The NPI 1811465594 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 11/11/2018 and was last updated on 1/30/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	023823	OHIO	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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