Healthcare Provider Details

I. General information

NPI: 1346053501
Provider Name (Legal Business Name): JESSICA LEIGH SPEARS FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/30/2025
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 PIKE ST STE 2
MARIETTA OH
45750-3507
US

IV. Provider business mailing address

521 5TH ST
MARIETTA OH
45750-1909
US

V. Phone/Fax

Practice location:
  • Phone: 740-373-3960
  • Fax: 740-373-3965
Mailing address:
  • Phone: 740-350-4945
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.003845
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: