Provider Demographics
NPI:1518446178
Name:ANNICHINE, JOEY MICHELLE (APRN-CNP)
Entity Type:Individual
Prefix:MRS
First Name:JOEY
Middle Name:MICHELLE
Last Name:ANNICHINE
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1306 MERE CT
Mailing Address - Street 2:
Mailing Address - City:BOARDMAN
Mailing Address - State:OH
Mailing Address - Zip Code:44512-3715
Mailing Address - Country:US
Mailing Address - Phone:330-716-4277
Mailing Address - Fax:
Practice Address - Street 1:1306 MERE CT
Practice Address - Street 2:
Practice Address - City:BOARDMAN
Practice Address - State:OH
Practice Address - Zip Code:44512-3715
Practice Address - Country:US
Practice Address - Phone:330-716-4277
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-14
Last Update Date:2018-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH023436363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily