MEDICARE: ANNE MARIE SALES NP / CNS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2200X	Adult Health Nurse Practitioner	363LA2200X	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	NP04613	OTHER	OH	NP LICENSE
3	RN217991	OTHER	OH	RN LICENSE
4	NS01154	OTHER	OH	CNS LICENSE NUMBER

General Provider Information

NPI Number	:	1649352055
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNE MARIE SALES NP / CNS

Provider Business Mailing Address
First Line	:	300 E 185TH ST
Second Line	:
City	:	EUCLID
State	:	OH
Zip	:	44119-1330
Country	:	US
Telephone Number	:	216-832-9703
Fax Number	:	216-227-9232

Provider Business Practice Location Address
First Line	:	300 E 185TH ST
Second Line	:
City	:	EUCLID
State	:	OH
Zip	:	44119-1330
Country	:	US
Telephone Number	:	216-832-9703
Fax Number	:	216-227-9232

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/19/2006
Last Update Date	:	07/08/2007

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