Healthcare Provider Details

I. General information

NPI: 1346051638
Provider Name (Legal Business Name): NANCY MILLER MONK HOAGLAND MSN, APRN, PMHNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/15/2025
Last Update Date: 02/19/2025
Certification Date: 02/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

236 3RD ST SW
CANTON OH
44702-1607
US

IV. Provider business mailing address

236 3RD ST SW
CANTON OH
44702-1607
US

V. Phone/Fax

Practice location:
  • Phone: 330-754-4431
  • Fax: 330-244-8839
Mailing address:
  • Phone: 330-754-4431
  • Fax: 330-244-8839

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number0038454
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: