Healthcare Provider Details

I. General information

NPI: 1922065887
Provider Name (Legal Business Name): CAROL JEAN CANT RN
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 04/26/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1370 BEULAH RD BUILDING 701
PITTSBURGH PA
15235-5068
US

IV. Provider business mailing address

1521 WESLEY ST
MCKEESPORT PA
15132-5638
US

V. Phone/Fax

Practice location:
  • Phone: 412-473-6759
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberRN220688L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: