Healthcare Provider Details

I. General information

NPI: 1578196366
Provider Name (Legal Business Name): JANNINE NICOLE MCGINNIS CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/19/2020
Last Update Date: 06/30/2025
Certification Date: 06/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1302 MERCY DRIVE NW MERCY HOSPITAL CLEVELAND CLINIC
CANTON OH
44708
US

IV. Provider business mailing address

1302 MERCY DR NORTHWEST
CANTON OH
44708
US

V. Phone/Fax

Practice location:
  • Phone: 330-344-2273
  • Fax:
Mailing address:
  • Phone: 330-344-2273
  • Fax: 330-430-6957

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberSP021504
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number.023665
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberSP021504
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: