Healthcare Provider Details

I. General information

NPI: 1265698393
Provider Name (Legal Business Name): SALLY ANNE STIEBER N.P.-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2008
Last Update Date: 08/06/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 W STRUB RD SUITE 330
SANDUSKY OH
44870-5366
US

IV. Provider business mailing address

2500 W STRUB RD SUITE 330
SANDUSKY OH
44870-5366
US

V. Phone/Fax

Practice location:
  • Phone: 419-626-6700
  • Fax: 419-626-6710
Mailing address:
  • Phone: 419-626-6700
  • Fax: 419-626-6710

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number10107-NP
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: