Healthcare Provider Details

I. General information

NPI: 1073923520
Provider Name (Legal Business Name): DEBORAH SPRADLIN CNS, BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/06/2014
Last Update Date: 05/06/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 HOSPITAL DR
BATAVIA OH
45103-1921
US

IV. Provider business mailing address

3000 HOSPITAL DR
BATAVIA OH
45103-1921
US

V. Phone/Fax

Practice location:
  • Phone: 513-732-8741
  • Fax: 513-732-8626
Mailing address:
  • Phone: 513-732-8741
  • Fax: 513-732-8626

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License NumberRN173925 COA1
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License NumberRX.08792-EX1
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: