Healthcare Provider Details

I. General information

NPI: 1679530919
Provider Name (Legal Business Name): RITA HANUSCHOCK CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2006
Last Update Date: 03/10/2021
Certification Date: 03/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 ARCH ST STE 410
AKRON OH
44304-1433
US

IV. Provider business mailing address

1077 GORGE BLVD
AKRON OH
44310-2408
US

V. Phone/Fax

Practice location:
  • Phone: 330-375-7474
  • Fax: 330-375-6129
Mailing address:
  • Phone: 330-375-7474
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRN178665
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: