Provider Demographics
NPI:1568435493
Name:SPANGLER, GLENN EDWARD (RN)
Entity Type:Individual
Prefix:MR
First Name:GLENN
Middle Name:EDWARD
Last Name:SPANGLER
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 1:157 MAPLEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:CHILLICOTHE
Mailing Address - State:OH
Mailing Address - Zip Code:45601-1724
Mailing Address - Country:US
Mailing Address - Phone:740-774-4040
Mailing Address - Fax:
Practice Address - Street 1:157 MAPLEWOOD DR
Practice Address - Street 2:
Practice Address - City:CHILLICOTHE
Practice Address - State:OH
Practice Address - Zip Code:45601-1724
Practice Address - Country:US
Practice Address - Phone:740-774-4040
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN 243698163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2275167Medicare ID - Type UnspecifiedINDEPENDENT PROVIDER NUMB