Laurie Jean Fitzgibbon, NP-C, CCNS

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

COA.18318-NP Issued in OH

Practice address

1330 Mercy Dr NW
Suite 418
Canton, OH 44708-2626

Phone

(330) 489-1454

NPI assigned

Dec 17, 2015

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1450310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452038400000",
    "number": "1902261944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 932100",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441930008",
            "telephone_number": "216-472-2730",
            "fax_number": "216-472-2740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 MERCY DR NW",
            "address_2": "SUITE 418",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447082626",
            "telephone_number": "330-489-1454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZGIBBON",
        "first_name": "LAURIE",
        "middle_name": "JEAN",
        "credential": "NP-C, CCNS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-17",
        "last_updated": "2016-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OH",
            "license": "COA.18318-NP",
            "primary": true
        },
        {
            "code": "364SA2100X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Acute Care",
            "state": "OH",
            "license": "COA.10052-NS",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0152995",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tiffany M. Fisher, PA-C
• Brooke Nicol Fisk, COTA/L
• Dana M Fisk, LPN
• Timothy P Fitch, LPC
• Megan Fitzgerald, RD, LD
• Erin Lynn Fitzpatrick, PA-C
• Caryn Patricia Flage
• Ben J Flagel, OD
• Kathleen Flaherty, PHD, CNS, RN
• Tara Flakes, MFT

• Adult Health Nurse Practitioner in Canton, OH
• Providers in Canton, OH by specialty
• Adult Health Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.