MEDICARE: KRISTIN BAKER SPITZNAGEL PA-C

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	363A00000X	Physician Assistant	50.003438	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1952685075
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTIN BAKER SPITZNAGEL PA-C

Provider Business Mailing Address
First Line	:	2830 VICTORY PARKWAY
Second Line	:	PAYOR ENROLLMENT
City	:	CINCINNATI
State	:	OH
Zip	:	45206-1785
Country	:	US
Telephone Number	:	513-585-5507
Fax Number	:

Provider Business Practice Location Address
First Line	:	6645 PRINCETON GLENDALE RD
Second Line	:
City	:	LIBERTY TWP
State	:	OH
Zip	:	45011-7547
Country	:	US
Telephone Number	:	513-829-2883
Fax Number	:	513-829-6346

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

Provider Enumeration Date	:	10/07/2011
Last Update Date	:	05/07/2020

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Directions to “ KRISTIN BAKER SPITZNAGEL PA-C” Practice Location

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