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General NPI Number Information
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NPI Number | 1720086630
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Entity Type | Individual
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Provider Name | SANDRA M. NUZUM CNM
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Gender | Female
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Dates
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Enumeration Date | 07/13/2005
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Last Update Date | 08/02/2017
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Provider Practice Location Address
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Address Line | 2751 BAY PARK DR. SUITE #300
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City | OREGON
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State | OH
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Zip | 43616
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Country | US
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Telephone | 419-690-7596
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Fax | 419-697-6707
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Provider Business Mailing Address
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Address Line | 4235 SECOR RD
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City | TOLEDO
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State | OH
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Zip | 43623-4231
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Country | US
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Telephone | 419-872-3201
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Fax | 419-872-3208
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number | APRNCNM07498
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License Number State | OH
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