MEDICARE: JENNIFER RANA SPICER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	374U00000X	Home Health Aide	0138896	OH

General Provider Information

NPI Number	:	1790393817
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER RANA SPICER

Provider Business Mailing Address
First Line	:	213 ESSEX RD
Second Line	:
City	:	VERMILION
State	:	OH
Zip	:	44089-2233
Country	:	US
Telephone Number	:	440-258-5889
Fax Number	:

Provider Business Practice Location Address
First Line	:	213 ESSEX RD
Second Line	:
City	:	VERMILION
State	:	OH
Zip	:	44089-2233
Country	:	US
Telephone Number	:	440-258-5889
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/14/2020
Last Update Date	:	07/14/2020

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Directions to “ JENNIFER RANA SPICER ” Practice Location

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