Provider Demographics
NPI:1689005563
Name:CANINI, ELISABETTA (CNP)
Entity Type:Individual
Prefix:
First Name:ELISABETTA
Middle Name:
Last Name:CANINI
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 1:3855 TRUEMAN COURT
Mailing Address - Street 2:
Mailing Address - City:HILLIARD
Mailing Address - State:OH
Mailing Address - Zip Code:43026
Mailing Address - Country:US
Mailing Address - Phone:614-777-1800
Mailing Address - Fax:
Practice Address - Street 1:3855 TRUEMAN COURT
Practice Address - Street 2:
Practice Address - City:HILLIARD
Practice Address - State:OH
Practice Address - Zip Code:43026
Practice Address - Country:US
Practice Address - Phone:614-777-1800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-03
Last Update Date:2013-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH340091363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner