MEDICARE: ANNE MARIE SIELSCHOTT APRN.CNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	APRN.CNP.024636	OH

General Provider Information

NPI Number	:	1104478098
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNE MARIE SIELSCHOTT APRN.CNP

Provider Business Mailing Address
First Line	:	830 W HIGH ST STE 250
Second Line	:
City	:	LIMA
State	:	OH
Zip	:	45801-3981
Country	:	US
Telephone Number	:	419-226-9037
Fax Number	:

Provider Business Practice Location Address
First Line	:	770 W HIGH ST STE 210
Second Line	:
City	:	LIMA
State	:	OH
Zip	:	45801-5902
Country	:	US
Telephone Number	:	419-226-9610
Fax Number	:	419-226-9602

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/11/2019
Last Update Date	:	03/25/2025

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