Healthcare Provider Details

I. General information

NPI: 1902414089
Provider Name (Legal Business Name): JUDY L LANEY WHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/15/2020
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5000 HIGBEE AVE NW
CANTON OH
44718-2582
US

IV. Provider business mailing address

605 N CLEVELAND MASSILLON RD
AKRON OH
44333-2200
US

V. Phone/Fax

Practice location:
  • Phone: 330-493-0313
  • Fax:
Mailing address:
  • Phone: 330-668-6545
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberAPRN.CNP.0026970
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: