Provider Demographics
NPI:1124313952
Name:SPAHR, LESLIE LAVONNE (LPN)
Entity type:Individual
Prefix:MISS
First Name:LESLIE
Middle Name:LAVONNE
Last Name:SPAHR
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5088 PEGGY ANN DR
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44319-3928
Mailing Address - Country:US
Mailing Address - Phone:330-644-3736
Mailing Address - Fax:
Practice Address - Street 1:5088 PEGGY ANN DR
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44319-3928
Practice Address - Country:US
Practice Address - Phone:330-644-3736
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-09
Last Update Date:2011-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.120790 IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse