Individual
DEBRA A ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1341 MARKET AVE N, CANTON, OH 44714-2605
(330) 453-8252
(330) 452-4655
Mailing address
625 CLEVELAND AVE NW, CANTON, OH 44702-1805
(330) 453-8252
(330) 453-6716
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN.123512.MEDS
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0244205
—
OH
Enumeration date
09/28/2017
Last updated
01/04/2023
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