Basic Information
Provider Information
NPI: 1497987283
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PARIS
FirstName: MARY FRANCES
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: CNS
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: PARIS
OtherFirstName: TERRI
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: CNS
OtherLastNameType: 5
Mailing Information
Address1: 2600 SIXTH STREET SW
Address2:  
City: CANTON
State: OH
PostalCode: 44710
CountryCode: US
TelephoneNumber: 3303632180
FaxNumber:  
Practice Location
Address1: 2600 SIXTH STREET SW
Address2:  
City: CANTON
State: OH
PostalCode: 44710
CountryCode: US
TelephoneNumber: 3303632180
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/13/2009
LastUpdateDate: 08/13/2009
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
364SA2200XCOA.10776-NSOHY Physician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health

No ID Information.


Home