Healthcare Provider Details

I. General information

NPI: 1568479053
Provider Name (Legal Business Name): CYNTHIA MAWER SCHMIDT CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2006
Last Update Date: 03/11/2020
Certification Date: 03/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

629 N SANDUSKY AVE
BUCYRUS OH
44820
US

IV. Provider business mailing address

2350 RANCHWOOD DR
MANSFIELD OH
44903
US

V. Phone/Fax

Practice location:
  • Phone: 419-562-4677
  • Fax: 419-563-9387
Mailing address:
  • Phone: 419-756-1690
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number036951
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: