Provider Demographics
NPI:1376906131
Name:SPINO, PATRICK (RN)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:
Last Name:SPINO
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1033 DEVLAC GRV
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:OH
Mailing Address - Zip Code:43402-4501
Mailing Address - Country:US
Mailing Address - Phone:419-352-6460
Mailing Address - Fax:419-352-3407
Practice Address - Street 1:1033 DEVLAC GRV
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:OH
Practice Address - Zip Code:43402-4501
Practice Address - Country:US
Practice Address - Phone:419-352-6460
Practice Address - Fax:419-352-3407
Is Sole Proprietor?:No
Enumeration Date:2016-03-30
Last Update Date:2016-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.243996163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse