Provider Demographics
NPI:1568486629
Name:CORNACCHIONE, CATHERINE ELIZABETH (CNP)
Entity Type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:ELIZABETH
Last Name:CORNACCHIONE
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:717 CANTON RD
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44312-2606
Mailing Address - Country:US
Mailing Address - Phone:330-733-4031
Mailing Address - Fax:330-733-7887
Practice Address - Street 1:717 CANTON RD
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44312-2606
Practice Address - Country:US
Practice Address - Phone:330-733-4031
Practice Address - Fax:330-733-7887
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2016-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNP-07827363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2551671OtherPARTNERS PHYSICIAN GROUP MEDICAID GROUP #
OH1841239274OtherPARTNERS PHYSICIAN GROUP TYPE 2 NPI #
OH2505300Medicaid
OH9338635OtherPARTNERS PHYSICIAN GROUP MEDICARE GROUP #
OH1164814414OtherAKRON GENERAL COMMUNITY ACCESS & WELLNESS -HWE TYPRE 2 NPI #
OH2505300Medicaid
OHH296250Medicare PIN