Provider Demographics
NPI:1669660924
Name:ERNSBERGER, ANITA CAROL (RN)
Entity Type:Individual
Prefix:MRS
First Name:ANITA
Middle Name:CAROL
Last Name:ERNSBERGER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:605 MAPLEWOOD ST
Mailing Address - Street 2:
Mailing Address - City:WILLARD
Mailing Address - State:OH
Mailing Address - Zip Code:44890-1545
Mailing Address - Country:US
Mailing Address - Phone:419-951-2063
Mailing Address - Fax:
Practice Address - Street 1:605 MAPLEWOOD ST
Practice Address - Street 2:
Practice Address - City:WILLARD
Practice Address - State:OH
Practice Address - Zip Code:44890-1545
Practice Address - Country:US
Practice Address - Phone:419-951-2063
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-11
Last Update Date:2007-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN279016163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse