Provider Demographics
NPI:1659739670
Name:SPRAGUE, EMILY (RN)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:SPRAGUE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:
Other - Last Name:KEARNS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1205 HIGHBRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:CUYAHOGA FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44223-2324
Mailing Address - Country:US
Mailing Address - Phone:330-592-3728
Mailing Address - Fax:
Practice Address - Street 1:1205 HIGHBRIDGE RD
Practice Address - Street 2:
Practice Address - City:CUYAHOGA FALLS
Practice Address - State:OH
Practice Address - Zip Code:44223-2324
Practice Address - Country:US
Practice Address - Phone:330-592-3728
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-04
Last Update Date:2016-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH382518163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse