Healthcare Provider Details

I. General information

NPI: 1962628792
Provider Name (Legal Business Name): ELLEN COLEEN SPINNER APRNCNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2007
Last Update Date: 04/16/2026
Certification Date: 04/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1835 E HIGH ST
SPRINGFIELD OH
45505-5210
US

IV. Provider business mailing address

700 ACKERMAN RD STE 2120
COLUMBUS OH
43202-1559
US

V. Phone/Fax

Practice location:
  • Phone: 937-328-0710
  • Fax: 937-328-0711
Mailing address:
  • Phone: 937-834-5320
  • Fax: 937-834-5322

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberAPRN.CNP.04620
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN.CNP.04620
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: