Provider Demographics
NPI:1972902633
Name:CONE, QANIQUE SHANEAL
Entity type:Individual
Prefix:
First Name:QANIQUE
Middle Name:SHANEAL
Last Name:CONE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 WOODVIEW ST SW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44706-5649
Mailing Address - Country:US
Mailing Address - Phone:330-356-3223
Mailing Address - Fax:
Practice Address - Street 1:1000 WOODVIEW ST SW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44706-5649
Practice Address - Country:US
Practice Address - Phone:330-356-3223
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-19
Last Update Date:2014-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH501031031005376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide