Provider Demographics
NPI:1659606481
Name:CANIANO, LAUREN ANN (ANP)
Entity Type:Individual
Prefix:MS
First Name:LAUREN
Middle Name:ANN
Last Name:CANIANO
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 TIMBERLINE DR
Mailing Address - Street 2:
Mailing Address - City:MORRISONVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12962-9696
Mailing Address - Country:US
Mailing Address - Phone:518-569-1808
Mailing Address - Fax:
Practice Address - Street 1:206 CORNELIA ST
Practice Address - Street 2:307
Practice Address - City:PLATTSBURGH
Practice Address - State:NY
Practice Address - Zip Code:12901-2779
Practice Address - Country:US
Practice Address - Phone:518-562-7705
Practice Address - Fax:518-562-7706
Is Sole Proprietor?:No
Enumeration Date:2009-10-13
Last Update Date:2009-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF305266-1363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner