Healthcare Provider Details

I. General information

NPI: 1518155548
Provider Name (Legal Business Name): ASHLEY DANIELLE CANNADY RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2007
Last Update Date: 05/11/2021
Certification Date: 05/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4976 OAKLAND DR
LYNDHURST OH
44124-2360
US

IV. Provider business mailing address

4976 OAKLAND DR
LYNDHURST OH
44124-2360
US

V. Phone/Fax

Practice location:
  • Phone: 440-341-4606
  • Fax:
Mailing address:
  • Phone: 440-341-4606
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License NumberPN112784
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberRN355421
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: