Provider Demographics
NPI:1225709975
Name:SPARKS, ALISHA NICHOLE
Entity Type:Individual
Prefix:
First Name:ALISHA
Middle Name:NICHOLE
Last Name:SPARKS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2933 FRANCIS SCOTT KEY WAY
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43207-6559
Mailing Address - Country:US
Mailing Address - Phone:614-749-0806
Mailing Address - Fax:
Practice Address - Street 1:2933 FRANCIS SCOTT KEY WAY
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43207-6559
Practice Address - Country:US
Practice Address - Phone:614-749-0806
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-22
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health