Provider Demographics
NPI:1902336282
Name:SPRUILL, SHARON (RN)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:
Last Name:SPRUILL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8087 WASHINGTON VILLAGE DR STE 120
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45458-1873
Mailing Address - Country:US
Mailing Address - Phone:937-203-4848
Mailing Address - Fax:927-203-4370
Practice Address - Street 1:8087 WASHINGTON VILLAGE DR STE 120
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45458-1873
Practice Address - Country:US
Practice Address - Phone:937-203-4848
Practice Address - Fax:937-203-4370
Is Sole Proprietor?:No
Enumeration Date:2017-06-19
Last Update Date:2017-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.194865163WH1000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH1000XNursing Service ProvidersRegistered NurseHospice