Healthcare Provider Details

I. General information

NPI: 1083124531
Provider Name (Legal Business Name): AMY LYNN CANIFF FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2017
Last Update Date: 09/20/2024
Certification Date: 09/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 JOHNSON RD
STEUBENVILLE OH
43952-2364
US

IV. Provider business mailing address

4000 JOHNSON RD
STEUBENVILLE OH
43952-2364
US

V. Phone/Fax

Practice location:
  • Phone: 740-264-8000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN77385-FNP-BC
License Number StateWV
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.021869
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: