Provider Demographics
NPI:1043072093
Name:ANSPACH, STEPHANIE ERIN
Entity Type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:ERIN
Last Name:ANSPACH
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:STEPHANIE
Other - Middle Name:ERIN
Other - Last Name:ROETTING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:969 STATE ROUTE 28 LOT 5
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:OH
Mailing Address - Zip Code:45150-5902
Mailing Address - Country:US
Mailing Address - Phone:513-849-3676
Mailing Address - Fax:
Practice Address - Street 1:969 STATE ROUTE 28 LOT 5
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:OH
Practice Address - Zip Code:45150-5902
Practice Address - Country:US
Practice Address - Phone:513-849-3676
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-25
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide