Provider Demographics
NPI:1346835246
Name:SPITLER, SARAH NICHOLE
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:NICHOLE
Last Name:SPITLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1853 LONG RUN RD
Mailing Address - Street 2:
Mailing Address - City:LOST CREEK
Mailing Address - State:WV
Mailing Address - Zip Code:26385-7423
Mailing Address - Country:US
Mailing Address - Phone:304-476-1135
Mailing Address - Fax:
Practice Address - Street 1:701 BENONI AVE
Practice Address - Street 2:
Practice Address - City:FAIRMONT
Practice Address - State:WV
Practice Address - Zip Code:26554-0045
Practice Address - Country:US
Practice Address - Phone:681-404-6135
Practice Address - Fax:681-404-6144
Is Sole Proprietor?:No
Enumeration Date:2021-03-03
Last Update Date:2021-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator