Provider Demographics
NPI:1265513105
Name:SPANGLER, AMY (CNP)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:SPANGLER
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43604-1516
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2121 HUGHES DR STE 750
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43606-5131
Practice Address - Country:US
Practice Address - Phone:419-291-7800
Practice Address - Fax:419-479-3282
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.05156363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH4446832Medicaid
OH2198054Medicaid
OH2198054Medicaid
OH500026039Medicare PIN
OHSPNP04302Medicare PIN