Healthcare Provider Details

I. General information

NPI: 1548177355
Provider Name (Legal Business Name): ANNMARIE ALTMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1079 FAIRVIEW AVE
BOWLING GREEN OH
43402-1234
US

IV. Provider business mailing address

1079 FAIRVIEW AVE
BOWLING GREEN OH
43402-1234
US

V. Phone/Fax

Practice location:
  • Phone: 419-354-0200
  • Fax: 419-353-1958
Mailing address:
  • Phone: 419-354-0200
  • Fax: 419-353-1958

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License NumberRN256924
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: