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General NPI Number Information
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NPI Number | 1144834862
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Entity Type | Individual
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Provider Name | MIRANDA JULIA SPILLETT
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Gender | Female
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Dates
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Enumeration Date | 09/01/2020
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Last Update Date | 09/01/2020
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Provider Practice Location Address
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Address Line | 5890 MONROE ST
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City | SYLVANIA
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State | OH
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Zip | 43560-2200
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Country | US
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Telephone | 419-882-5860
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Fax |
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Provider Business Mailing Address
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Address Line | 7051 NIGHTINGALE DR
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City | HOLLAND
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State | OH
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Zip | 43528-7821
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Country | US
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Telephone | 419-290-5740
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 03440151
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License Number State | OH
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