Healthcare Provider Details

I. General information

NPI: 1952235459
Provider Name (Legal Business Name): STEPHANIE SINES APRN, CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 WINZELER DR STE 5
BRYAN OH
43506-8303
US

IV. Provider business mailing address

2975 EVANSPORT RD
DEFIANCE OH
43512-9620
US

V. Phone/Fax

Practice location:
  • Phone: 419-349-0941
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0040072
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: