Individual
MRS. MARYBETH KATHLEEN HANNUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN-PC
Contact information
Practice address
6076 WHIPPLE AVE NW, NORTH CANTON, OH 44720-7616
(330) 433-1777
(330) 305-5001
Mailing address
6076 WHIPPLE AVE NW, NORTH CANTON, OH 44720-7616
(330) 433-1777
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
.025045
OH
363LP0200X
Pediatric Nurse Practitioner
.025045
OH
Other
Enumeration date
07/07/2019
Last updated
02/23/2021
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