Healthcare Provider Details

I. General information

NPI: 1780660688
Provider Name (Legal Business Name): ANNA FRABOTTA APRN, BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANNA DIVINCENZO

II. Dates (important events)

Enumeration Date: 12/22/2005
Last Update Date: 04/20/2021
Certification Date: 04/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 PERKINS SQ
AKRON OH
44308-1063
US

IV. Provider business mailing address

1 PERKINS SQ
AKRON OH
44308-1063
US

V. Phone/Fax

Practice location:
  • Phone: 330-543-6060
  • Fax: 330-543-8463
Mailing address:
  • Phone: 330-543-6060
  • Fax: 330-543-8463

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberCOA.05385-NP
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: