Healthcare Provider Details

I. General information

NPI: 1386256139
Provider Name (Legal Business Name): GIANNA RAE MARGIOTTA DSP, HHA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/21/2020
Last Update Date: 08/21/2020
Certification Date: 08/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

132 ENGLEWOOD RD
SPRINGFIELD OH
45504-1415
US

IV. Provider business mailing address

132 ENGLEWOOD RD
SPRINGFIELD OH
45504-1415
US

V. Phone/Fax

Practice location:
  • Phone: 937-727-2179
  • Fax:
Mailing address:
  • Phone: 937-727-2179
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number3651885
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: