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General NPI Number Information
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NPI Number | 1053989285
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Entity Type | Individual
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Provider Name | TIFFANY ANN MARIE SPANGLER
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Gender | Female
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Dates
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Enumeration Date | 06/14/2021
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Last Update Date | 06/14/2021
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Provider Practice Location Address
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Address Line | 755 OTTAWA ST
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City | KALIDA
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State | OH
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Zip | 45853-2096
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Country | US
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Telephone | 419-532-2961
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Fax | 419-532-2962
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Provider Business Mailing Address
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Address Line | 5163 ROAD 215
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City | OAKWOOD
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State | OH
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Zip | 45873-9513
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Country | US
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Telephone | 419-796-8073
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WA2000X
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Taxonomy Name | Administrator Registered Nurse
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License Number | RN.464343
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License Number State | OH
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