Healthcare Provider Details

I. General information

NPI: 1609788439
Provider Name (Legal Business Name): FALLON VANCE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 WHITE POND DR STE 300
AKRON OH
44320-1193
US

IV. Provider business mailing address

1944 TUDOR ST
CUYAHOGA FALLS OH
44221-4120
US

V. Phone/Fax

Practice location:
  • Phone: 330-572-1011
  • Fax:
Mailing address:
  • Phone: 330-715-8788
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License NumberAPRN.CNS.0019549
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: