Provider Demographics
NPI:1518446178
Name:ANNICHINE, JOEY MICHELLE (APRN-CNP)
Entity type:Individual
Prefix:MRS
First Name:JOEY
Middle Name:MICHELLE
Last Name:ANNICHINE
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:100 DEBARTOLO PL STE 200
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44512-6095
Mailing Address - Country:US
Mailing Address - Phone:330-729-8145
Mailing Address - Fax:330-965-5229
Practice Address - Street 1:425 ROBBINS AVE
Practice Address - Street 2:
Practice Address - City:NILES
Practice Address - State:OH
Practice Address - Zip Code:44446-2409
Practice Address - Country:US
Practice Address - Phone:234-297-0028
Practice Address - Fax:234-338-9795
Is Sole Proprietor?:No
Enumeration Date:2018-08-14
Last Update Date:2025-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.023436363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0329450Medicaid