Healthcare Provider Details

I. General information

NPI: 1598383473
Provider Name (Legal Business Name): ANNA T BURRAGE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/08/2020
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9202 SOLON DR
CINCINNATI OH
45242-4618
US

IV. Provider business mailing address

9202 SOLON DR
CINCINNATI OH
45242-4618
US

V. Phone/Fax

Practice location:
  • Phone: 513-954-8583
  • Fax: 513-954-5838
Mailing address:
  • Phone: 513-200-9769
  • Fax: 513-954-5838

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License NumberAPS.002779
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License NumberCHW-000214
License Number StateOH
# 4
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License NumberAPS.002779
License Number State
# 5
Primary TaxonomyY
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number39371
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: