Provider Demographics
NPI:1740031020
Name:HANEY, CHINTANA ANN (CPNP)
Entity type:Individual
Prefix:
First Name:CHINTANA
Middle Name:ANN
Last Name:HANEY
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:TANA
Other - Middle Name:
Other - Last Name:HANEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CPNP
Mailing Address - Street 1:830 W HIGH ST STE 102
Mailing Address - Street 2:
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45801-3972
Mailing Address - Country:US
Mailing Address - Phone:419-957-2810
Mailing Address - Fax:
Practice Address - Street 1:830 W HIGH ST
Practice Address - Street 2:
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45801-3971
Practice Address - Country:US
Practice Address - Phone:419-222-4045
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-27
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0035987363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics