=====================================================
General NPI Number Information
=====================================================
NPI Number | 1356203384
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SPIRIT NURSE CREATIONS
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/28/2025
-----------------------------------------------------
Last Update Date | 11/28/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1761 CLIFTON AVE
-----------------------------------------------------
City | SPRINGFIELD
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45505-4007
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 937-624-2559
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3351 RED COACH DR
-----------------------------------------------------
City | SPRINGFIELD
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45503-1201
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 937-624-2559
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | REGISTERED NURSE
-----------------------------------------------------
Name | SHANTEL RENE WITHERSPOON
-----------------------------------------------------
Credential | RN
-----------------------------------------------------
Telephone | 937-624-2559
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------