=====================================================
General NPI Number Information
=====================================================
NPI Number | 1619881836
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SPRING ANGEL RHOADES LPN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/02/2026
-----------------------------------------------------
Last Update Date | 10/02/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4297 BROADWAY ST
-----------------------------------------------------
City | SOUTH SALEM
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45681-9014
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 937-981-2673
-----------------------------------------------------
Fax | 937-981-1924
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 200 N 5TH ST
-----------------------------------------------------
City | GREENFIELD
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45123-1373
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 937-981-2152
-----------------------------------------------------
Fax | 937-981-4395
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 164W00000X
-----------------------------------------------------
Taxonomy Name | Licensed Practical Nurse
-----------------------------------------------------
License Number | 147709
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------