MEDICARE: JENNIFER L SPRENGER

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	376K00000X	Nurse's Aide		OH

General Provider Information

NPI Number	:	1639202328
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER L SPRENGER

Provider Business Mailing Address
First Line	:	5115 E LAKE RD APT 605
Second Line	:
City	:	SHEFFIELD LAKE
State	:	OH
Zip	:	44054-1736
Country	:	US
Telephone Number	:	216-466-1064
Fax Number	:

Provider Business Practice Location Address
First Line	:	5115 E LAKE RD APT 605
Second Line	:
City	:	SHEFFIELD LAKE
State	:	OH
Zip	:	44054-1736
Country	:	US
Telephone Number	:	216-466-1064
Fax Number	:

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

Provider Enumeration Date	:	03/13/2007
Last Update Date	:	07/08/2007

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