Provider Demographics
NPI:1770054470
Name:SEFIC, ANN MARIE (RN)
Entity type:Individual
Prefix:MS
First Name:ANN
Middle Name:MARIE
Last Name:SEFIC
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 1:88 RYDER CT APT 3
Mailing Address - Street 2:
Mailing Address - City:BELLBROOK
Mailing Address - State:OH
Mailing Address - Zip Code:45305-2020
Mailing Address - Country:US
Mailing Address - Phone:937-848-0288
Mailing Address - Fax:
Practice Address - Street 1:88 RYDER CT APT 3
Practice Address - Street 2:
Practice Address - City:BELLBROOK
Practice Address - State:OH
Practice Address - Zip Code:45305-2020
Practice Address - Country:US
Practice Address - Phone:937-848-0288
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-07
Last Update Date:2018-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.246841163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health