Healthcare Provider Details

I. General information

NPI: 1184657165
Provider Name (Legal Business Name): CATHERINE L. BUSWELL APRN.CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 06/24/2024
Certification Date: 06/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1844 W STATE ST
ALLIANCE OH
44601-5771
US

IV. Provider business mailing address

624 MARKET AVE N
CANTON OH
44702-1017
US

V. Phone/Fax

Practice location:
  • Phone: 330-493-4553
  • Fax: 330-493-3761
Mailing address:
  • Phone: 330-493-4553
  • Fax: 330-493-3761

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number71003239A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code364SP0808X
TaxonomyPsychiatric/Mental Health Clinical Nurse Specialist
License NumberRN178406 CNS/PMH
License Number StateGA
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN.CNP.020380
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: