Provider Demographics
NPI:1760671721
Name:SPROUSE, JOYCE A (RN)
Entity Type:Individual
Prefix:
First Name:JOYCE
Middle Name:A
Last Name:SPROUSE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40444 APPLEGATE RD
Mailing Address - Street 2:
Mailing Address - City:LISBON
Mailing Address - State:OH
Mailing Address - Zip Code:44432-9648
Mailing Address - Country:US
Mailing Address - Phone:330-424-3501
Mailing Address - Fax:
Practice Address - Street 1:40444 APPLEGATE RD
Practice Address - Street 2:
Practice Address - City:LISBON
Practice Address - State:OH
Practice Address - Zip Code:44432-9648
Practice Address - Country:US
Practice Address - Phone:330-424-3501
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-16
Last Update Date:2007-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN275370163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse