Healthcare Provider Details

I. General information

NPI: 1891518171
Provider Name (Legal Business Name): ALYSON LYNN SPILLER CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALYSON LYNN SPEARS

II. Dates (important events)

Enumeration Date: 11/05/2024
Last Update Date: 02/27/2025
Certification Date: 02/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2141 N FAIRFIELD RD STE 125
BEAVERCREEK OH
45431-2578
US

IV. Provider business mailing address

1479 CAMERON DR
FAIRBORN OH
45324-8547
US

V. Phone/Fax

Practice location:
  • Phone: 937-458-0085
  • Fax:
Mailing address:
  • Phone: 937-478-9219
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAPRN.CNP.0037331
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberAPRN.CNP.0037331
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: