Healthcare Provider Details

I. General information

NPI: 1023215126
Provider Name (Legal Business Name): ANNE BAGSHAW RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2007
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2136 W 8TH ST
CINCINNATI OH
45204-2052
US

IV. Provider business mailing address

550 LUDLOW ST
GREENDALE IN
47025-1535
US

V. Phone/Fax

Practice location:
  • Phone: 513-357-2808
  • Fax:
Mailing address:
  • Phone: 812-537-1966
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberNP-01697
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN220730
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: