Healthcare Provider Details

I. General information

NPI: 1497662738
Provider Name (Legal Business Name): LANI MITCHELL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 E MARKET ST
AKRON OH
44308-2036
US

IV. Provider business mailing address

4722 BLUEBERRY AVE NW
CANTON OH
44709-1313
US

V. Phone/Fax

Practice location:
  • Phone: 330-302-2733
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License NumberLPN196762
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: