Provider Demographics
NPI:1306620489
Name:WLODARSKI, ANNA (CMA-C)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:WLODARSKI
Suffix:
Gender:F
Credentials:CMA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1233
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:OH
Mailing Address - Zip Code:43528-1233
Mailing Address - Country:US
Mailing Address - Phone:360-319-1008
Mailing Address - Fax:
Practice Address - Street 1:1034 HAWK ST
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43612-2815
Practice Address - Country:US
Practice Address - Phone:360-319-1008
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-21
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No372600000XNursing Service Related ProvidersAdult Companion
No374U00000XNursing Service Related ProvidersHome Health Aide
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider
Provider Identifiers
StateIdentifier IDID TypeIssuer
WACM61202240OtherCERTIFIED MEDICAL ASSISTANT