Healthcare Provider Details

I. General information

NPI: 1871302984
Provider Name (Legal Business Name): ROBIN SUE SPONHALTZ LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/03/2025
Last Update Date: 02/24/2025
Certification Date: 02/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 LOCUST LN
SAINT CLAIRSVILLE OH
43950-1568
US

IV. Provider business mailing address

115 LOCUST LN
SAINT CLAIRSVILLE OH
43950-1568
US

V. Phone/Fax

Practice location:
  • Phone: 740-391-5515
  • Fax:
Mailing address:
  • Phone: 740-391-5515
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number124445
License Number StateOH
# 4
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number124445.MEDS
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: