Provider Demographics
NPI:1285959072
Name:MCNEILL, ANN MARIE (CNP)
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:MARIE
Last Name:MCNEILL
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 1:1883 SPERRYS FORGE TRL
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145-2071
Mailing Address - Country:US
Mailing Address - Phone:440-821-1054
Mailing Address - Fax:
Practice Address - Street 1:7007 POWERS BLVD
Practice Address - Street 2:
Practice Address - City:PARMA
Practice Address - State:OH
Practice Address - Zip Code:44129-5437
Practice Address - Country:US
Practice Address - Phone:440-523-0259
Practice Address - Fax:440-345-5000
Is Sole Proprietor?:No
Enumeration Date:2010-04-05
Last Update Date:2013-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA11390NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3056759Medicaid
OHNP35181Medicare PIN
OH0236248Medicare PIN
OH9284951Medicare PIN