Healthcare Provider Details

I. General information

NPI: 1780320739
Provider Name (Legal Business Name): KRISTIE ANELLO CPNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2022
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2121 HUGHES DR STE 500
TOLEDO OH
43606-3857
US

IV. Provider business mailing address

2121 HUGHES DR STE 500
TOLEDO OH
43606-3857
US

V. Phone/Fax

Practice location:
  • Phone: 567-585-8950
  • Fax: 567-585-8952
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberAPRN.CNP.0031459
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License NumberRN.399217
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: