Provider Demographics
NPI:1154620029
Name:SIERS, MILDRED ANN (CNP)
Entity type:Individual
Prefix:
First Name:MILDRED
Middle Name:ANN
Last Name:SIERS
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:P.O. BOX 16370
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43216-6370
Mailing Address - Country:US
Mailing Address - Phone:614-645-5500
Mailing Address - Fax:
Practice Address - Street 1:3334 AGLER ROAD
Practice Address - Street 2:SUITE 2800
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43219-3387
Practice Address - Country:US
Practice Address - Phone:614-645-1600
Practice Address - Fax:614-645-1348
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-17
Last Update Date:2012-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN185051-COA1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily