Provider Demographics
NPI:1548231798
Name:BROZ, ANNA MARIA (CNP)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:MARIA
Last Name:BROZ
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29325 HEALTH CAMPUS DR
Mailing Address - Street 2:SUITE 3
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145-8201
Mailing Address - Country:US
Mailing Address - Phone:440-414-9412
Mailing Address - Fax:440-414-9059
Practice Address - Street 1:3600 KOLBE RD
Practice Address - Street 2:SUITE 127
Practice Address - City:LORAIN
Practice Address - State:OH
Practice Address - Zip Code:44053-1654
Practice Address - Country:US
Practice Address - Phone:440-414-9100
Practice Address - Fax:440-282-7579
Is Sole Proprietor?:No
Enumeration Date:2006-01-27
Last Update Date:2011-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNP-03480363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
500004283OtherRAILROAD MEDICARE
OH2219101Medicaid
OH000000342758OtherANTHEM
OH000000342758OtherANTHEM
OH2219101Medicaid