MEDICARE: SHARDAE C SPRAGLING

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	320396940422	OH

General Provider Information

NPI Number	:	1891493466
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHARDAE C SPRAGLING

Provider Business Mailing Address
First Line	:	3952 TIMBERVIEW ST NW APT 7
Second Line	:
City	:	NORTH CANTON
State	:	OH
Zip	:	44720-4707
Country	:	US
Telephone Number	:	480-493-7349
Fax Number	:

Provider Business Practice Location Address
First Line	:	3952 TIMBERVIEW ST NW APT 7
Second Line	:
City	:	NORTH CANTON
State	:	OH
Zip	:	44720-4707
Country	:	US
Telephone Number	:	480-493-7349
Fax Number	:

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

Provider Enumeration Date	:	02/22/2023
Last Update Date	:	02/22/2023

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Directions to “ SHARDAE C SPRAGLING ” Practice Location

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