MEDICARE: MRS. VICKI LYNN SPIRES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3747P1801X	Personal Care Attendant

General Provider Information

NPI Number	:	1053169045
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. VICKI LYNN SPIRES

Provider Business Mailing Address
First Line	:	1741 BAINUM RD
Second Line	:
City	:	NEW RICHMOND
State	:	OH
Zip	:	45157-8612
Country	:	US
Telephone Number	:	513-553-9314
Fax Number	:

Provider Business Practice Location Address
First Line	:	1741 BAINUM RD
Second Line	:
City	:	NEW RICHMOND
State	:	OH
Zip	:	45157-8612
Country	:	US
Telephone Number	:	513-553-9314
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/07/2024
Last Update Date	:	05/07/2024

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