Healthcare Provider Details

I. General information

NPI: 1790335149
Provider Name (Legal Business Name): ANNE M MAURIC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ANNE HAHN

II. Dates (important events)

Enumeration Date: 09/18/2019
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5420 MILAN RD STE C
SANDUSKY OH
44870-5846
US

IV. Provider business mailing address

1912 HAYES AVE STE 1
SANDUSKY OH
44870-4736
US

V. Phone/Fax

Practice location:
  • Phone: 419-557-6490
  • Fax: 419-557-6840
Mailing address:
  • Phone: 419-557-5541
  • Fax: 419-557-5542

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN.CNP.025606
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: