Healthcare Provider Details

I. General information

NPI: 1629859038
Provider Name (Legal Business Name): SEMBRIA SUGG APRN-CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/11/2023
Last Update Date: 09/20/2026
Certification Date: 09/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6935 MONCLOVA RD
MAUMEE OH
43537-9353
US

IV. Provider business mailing address

7684 ADLER RD
OTTAWA LAKE MI
49267-9533
US

V. Phone/Fax

Practice location:
  • Phone: 419-866-3030
  • Fax:
Mailing address:
  • Phone: 419-343-8632
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.0035114
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: