Healthcare Provider Details

I. General information

NPI: 1093214009
Provider Name (Legal Business Name): SUSAN KAY SPIEKER CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/05/2018
Last Update Date: 02/05/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

740 COLT DR
FINDLAY OH
45840-6471
US

IV. Provider business mailing address

1900 S MAIN ST
FINDLAY OH
45840-1214
US

V. Phone/Fax

Practice location:
  • Phone: 419-420-3778
  • Fax:
Mailing address:
  • Phone: 419-423-4500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPRN.CRNA.019653
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: