Healthcare Provider Details

I. General information

NPI: 1407690787
Provider Name (Legal Business Name): MICHAEL GIANNETTI
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/21/2024
Last Update Date: 06/26/2024
Certification Date: 06/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

260 SPRINGSIDE DR
AKRON OH
44333-2433
US

IV. Provider business mailing address

260 SPRINGSIDE DR
AKRON OH
44333-2433
US

V. Phone/Fax

Practice location:
  • Phone: 330-576-9700
  • Fax:
Mailing address:
  • Phone: 330-576-9700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN.CNP.0036822
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: