LAURIE JEAN FITZGIBBON (NPI# 1902261944) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1902261944 |
Entity Type | Individual |
Full Name | LAURIE JEAN FITZGIBBON |
Credential | NP-C, CCNS |
Practice Address |
1330 Mercy Dr Nw Suite 418 Canton OH 44708-2626 |
Mailing Address |
Po Box 932100 Cleveland OH 44193-0008 |
Practice Telephone | 3304891454 |
Mailing Telephone | 2164722730 |
Mailing Fax Number | 2164722740 |
Enumeration Date | 2015-12-17 |
Last Update Date | 2016-01-06 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
COA.18318-NP | OH | Physician Assistants & Advanced Practice Nursing Providers |
N | 364SA2100X |
Clinical Nurse Specialist Specialization: Acute Care |
COA.10052-NS | OH | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
OH | 0152995 | 05 |
Street Address |
1330 MERCY DR NW SUITE 418 |
City | CANTON |
State | OH |
Zip Code | 44708-2626 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1215930946 | Mark Carless Stachel | Internal Medicine | 1330 Mercy Dr Nw, Ste 318, Canton, OH 44708-2624 | 2005-05-27 |
1407305402 | Lindsay Anne Haupt | Nurse Practitioner | 1330 Mercy Dr Nw, Canton, OH 44708-2626 | 2016-10-02 |
1235502303 | Amanda Michelle Johnson | Nurse Practitioner | 1330 Mercy Dr Nw, Suite 101, Canton, OH 44708-2626 | 2015-11-11 |
1245493477 | Heather B Lee | Physician Assistant | 1330 Mercy Dr Nw, Suite 101, Canton, OH 44708-2626 | 2008-07-08 |
1992980783 | Mazin Shackour | Surgery | 1330 Mercy Dr Nw, Suite 420, Canton, OH 44708-2626 | 2007-12-31 |
1649450669 | Simonette Carol Jones | Internal Medicine | 1330 Mercy Dr Nw, Suite 101, Canton, OH 44708-2626 | 2007-11-07 |
1649468240 | Stark Cardiothoracic Surgery, Inc | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1330 Mercy Dr Nw, Suite 410, Canton, OH 44708-2626 | 2007-10-09 |
1942414313 | Meena Rajan | Internal Medicine | 1330 Mercy Dr Nw, Canton, OH 44708-2626 | 2007-05-09 |
1922135136 | Michael Patrick Mccormack | Plastic Surgery | 1330 Mercy Dr Nw, Suite 522, Canton, OH 44708-2626 | 2007-02-27 |
1437201985 | Pulmonology Critical Care Physicians Inc. | Specialist | 1330 Mercy Dr Nw, Canton, OH 44708-2626 | 2007-01-17 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1669072583 | Xl Developmental Services, Inc. | Home Health | 4403 19th St Nw, Canton, OH 44708 | 2020-10-29 |
1942827084 | Emily Glor | Dentist | 1320 Mercy Drive Northwest, Attn: Dental Services, Canton, OH 44708 | 2020-07-05 |
1811479009 | Linda Adams | Counselor | 2421 13th Street Nw, Canton, OH 44708 | 2018-09-04 |
1104308527 | Toreka Lishay Miller | Social Worker | 2421 13th Nw, Canton, OH 44708 | 2018-09-01 |
1679051213 | Edward Arthur Hill | Family Medicine | 6104 Cedar Lane Nw, Canton, OH 44708 | 2018-08-06 |
1467939371 | Kristen M Reardon | Registered Nurse | 1330 Mercy Dr Nw Ste 319, Canton, OH 44708 | 2018-07-24 |
1538659131 | Jeffrey Scott Mechtenberg | Chiropractor | 3410 Tuscarawas Street W, Canton, OH 44708 | 2018-05-18 |
1699284844 | Our Caring Hands Home Care, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3005 W. Tuscuswas St, Canton, OH 44708 | 2017-09-20 |
1528580933 | Elizabeth Ann Bonchek | Licensed Practical Nurse | 4550 Hills and Dales Nw Road, Canton, OH 44708 | 2017-07-07 |
1518315837 | Bio-medical Applications of Ohio, Inc. | Clinic/Center | 2835 Tuscarawas St. West, Canton, OH 44708 | 2016-05-26 |
Find all providers in zip 44708 |
Taxonomy Code | 363LA2200X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Adult Health |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1487162319 | Mary Melvin Smith | Nurse Practitioner | 107 Cannon Run, Canton, MS 39046-8033 | 2018-01-12 |
1851838809 | Kristen Bourgon-yee | Nurse Practitioner | 236 Constitution St, Canton, MI 48188-6719 | 2017-01-30 |
1063883981 | Destiny Howe | Nurse Practitioner | 1610 Oakdale Rd, Canton, GA 30114-4512 | 2015-10-19 |
1912398827 | Andrea Johnson | Nurse Practitioner | 7440 Claremont St, Canton, MI 48187-1535 | 2015-02-13 |
1376973602 | Sarita Rao | Nurse Practitioner | 44270 Duchess Dr, Canton, MI 48187-3242 | 2013-11-22 |
1134476088 | Carla Valerie Hart-tyner | Nurse Practitioner | 3801 Whipple Ave Nw Ste 1, Canton, OH 44718-4802 | 2012-08-09 |
1902173560 | Abbey Baum-beigie | Nurse Practitioner | 626 34th Street Nw, Canton, OH 44709 | 2011-11-28 |
1073807855 | Sheri Sullins Buckley | Nurse Practitioner | 120 Oakside Ct Ste H, Canton, GA 30114 | 2011-06-08 |
1942502109 | Lynn A Nuti | Nurse Practitioner | 16 Forge Pond, Unit D, Canton, MA 02021-2995 | 2010-11-21 |
1841470010 | Wida M Miller | Nurse Practitioner | 2600 6th St Sw # A2-710, Canton, OH 44710-1702 | 2007-11-05 |
Find all providers in CANTON |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.