Provider Demographics
NPI:1649352055
Name:SALES, ANNE MARIE (NP / CNS)
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:MARIE
Last Name:SALES
Suffix:
Gender:F
Credentials:NP / CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 E 185TH ST
Mailing Address - Street 2:
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44119-1330
Mailing Address - Country:US
Mailing Address - Phone:216-832-9703
Mailing Address - Fax:216-227-9232
Practice Address - Street 1:300 E 185TH ST
Practice Address - Street 2:
Practice Address - City:EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44119-1330
Practice Address - Country:US
Practice Address - Phone:216-832-9703
Practice Address - Fax:216-227-9232
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH363LA2200X363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2619045Medicaid
OHNP04613OtherNP LICENSE
OHRN217991OtherRN LICENSE
OHNS01154OtherCNS LICENSE NUMBER
OHQ61034Medicare UPIN
OH2619045Medicaid