Provider Demographics
NPI:1477348142
Name:SPRAGGANS, MARQUITA
Entity type:Individual
Prefix:
First Name:MARQUITA
Middle Name:
Last Name:SPRAGGANS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:761 CORINTHIAN AVE APT B
Mailing Address - Street 2:
Mailing Address - City:PHILA
Mailing Address - State:PA
Mailing Address - Zip Code:19130-2168
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:761 CORINTHIAN AVE APT B
Practice Address - Street 2:
Practice Address - City:PHILA
Practice Address - State:PA
Practice Address - Zip Code:19130-2168
Practice Address - Country:US
Practice Address - Phone:215-939-8506
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-11
Last Update Date:2025-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA101YS0200X, 261QC0050X, 372600000X
347C00000X, 374U00000X, 390200000X, 261QH0100X
PA00000000372600000X, 376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool
No261QC0050XAmbulatory Health Care FacilitiesClinic/CenterCritical Access Hospital
No347C00000XTransportation ServicesPrivate Vehicle
No372600000XNursing Service Related ProvidersAdult CompanionGroup - Multi-Specialty
No374U00000XNursing Service Related ProvidersHome Health Aide
No376J00000XNursing Service Related ProvidersHomemaker
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program