Provider Demographics
NPI:1972703510
Name:VANIC, ANNE (RN,MS,CPNP,IBCLC)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:
Last Name:VANIC
Suffix:
Gender:F
Credentials:RN,MS,CPNP,IBCLC
Other - Prefix:
Other - First Name:ANNE
Other - Middle Name:M
Other - Last Name:KUNERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, MS, CPNP
Mailing Address - Street 1:135 QUAIL HOLLOW DR
Mailing Address - Street 2:
Mailing Address - City:MORELAND HILLS
Mailing Address - State:OH
Mailing Address - Zip Code:44022-1140
Mailing Address - Country:US
Mailing Address - Phone:440-893-0340
Mailing Address - Fax:
Practice Address - Street 1:6780 MAYFIELD RD
Practice Address - Street 2:
Practice Address - City:MAYFIELD HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44124-2203
Practice Address - Country:US
Practice Address - Phone:440-312-5332
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-23
Last Update Date:2007-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN-296155163WL0100X
OHNP-06564363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics