Provider Demographics
NPI:1902608821
Name:CANNIE, EVA HELENE (NICE HOME FURNISHED)
Entity type:Individual
Prefix:
First Name:EVA
Middle Name:HELENE
Last Name:CANNIE
Suffix:
Gender:
Credentials:NICE HOME FURNISHED
Other - Prefix:
Other - First Name:AVA
Other - Middle Name:ELECTRIS
Other - Last Name:CANNIE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:SINGER
Mailing Address - Street 1:12959 HUNT CLUB RD N
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32224-7674
Mailing Address - Country:US
Mailing Address - Phone:904-223-0204
Mailing Address - Fax:
Practice Address - Street 1:12959 HUNT CLUB RD N
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32224-7674
Practice Address - Country:US
Practice Address - Phone:904-223-0204
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-24
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker