Healthcare Provider Details

I. General information

NPI: 1780710665
Provider Name (Legal Business Name): DENNIS ALLEN MCCANN RNFA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/26/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3964 HAMILTON SQUARE BLVD
GROVEPORT OH
43125-9119
US

IV. Provider business mailing address

8835 VINEYARD HAVEN DR
DUBLIN OH
43016-7368
US

V. Phone/Fax

Practice location:
  • Phone: 614-834-6980
  • Fax:
Mailing address:
  • Phone: 614-873-3837
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SM0705X
TaxonomyMedical-Surgical Clinical Nurse Specialist
License NumberRN194728
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: