Healthcare Provider Details

I. General information

NPI: 1861155905
Provider Name (Legal Business Name): ANNA CRUZ CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/15/2021
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1922 GLEN SPRINGS DR
FREMONT OH
43420-3229
US

IV. Provider business mailing address

922 GLEN SPRINGS
FREMONT OH
43420
US

V. Phone/Fax

Practice location:
  • Phone: 419-333-2798
  • Fax:
Mailing address:
  • Phone: 419-333-2798
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberLE-00061197
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: