Provider Demographics
NPI:1669603585
Name:SPANGLER, JEAN MARA (RN)
Entity type:Individual
Prefix:
First Name:JEAN
Middle Name:MARA
Last Name:SPANGLER
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 1:230 S HAMBDEN ST
Mailing Address - Street 2:
Mailing Address - City:CHARDON
Mailing Address - State:OH
Mailing Address - Zip Code:44024-1229
Mailing Address - Country:US
Mailing Address - Phone:440-286-6466
Mailing Address - Fax:
Practice Address - Street 1:230 S HAMBDEN ST
Practice Address - Street 2:
Practice Address - City:CHARDON
Practice Address - State:OH
Practice Address - Zip Code:44024-1229
Practice Address - Country:US
Practice Address - Phone:440-286-6466
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-28
Last Update Date:2009-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH089026163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health