Provider Demographics
NPI:1366023095
Name:SPIRES, PATRICK JONATHAN (STNA)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:JONATHAN
Last Name:SPIRES
Suffix:
Gender:M
Credentials:STNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:805 E WHEELING ST APT 106
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:OH
Mailing Address - Zip Code:43130-3277
Mailing Address - Country:US
Mailing Address - Phone:740-304-5486
Mailing Address - Fax:
Practice Address - Street 1:805 E WHEELING ST APT 106
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:OH
Practice Address - Zip Code:43130-3277
Practice Address - Country:US
Practice Address - Phone:740-304-5486
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-15
Last Update Date:2021-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide