Provider Demographics
NPI:1326454604
Name:CANION, KANESHA TAMIA (RN)
Entity Type:Individual
Prefix:
First Name:KANESHA
Middle Name:TAMIA
Last Name:CANION
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:260 NORTHLAND BLVD STE 133A
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45246-4908
Mailing Address - Country:US
Mailing Address - Phone:513-259-9794
Mailing Address - Fax:
Practice Address - Street 1:260 NORTHLAND BLVD STE 133A
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45246-4908
Practice Address - Country:US
Practice Address - Phone:513-259-9794
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-07
Last Update Date:2022-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH151074164W00000X
OH488199163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No164W00000XNursing Service ProvidersLicensed Practical Nurse