Provider Demographics
NPI:1962115220
Name:SPILLETT, TALIA MARY-LOU (BSN, RN)
Entity type:Individual
Prefix:MISS
First Name:TALIA
Middle Name:MARY-LOU
Last Name:SPILLETT
Suffix:
Gender:F
Credentials:BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6954 WEXFORD HILL LN
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:OH
Mailing Address - Zip Code:43528-8893
Mailing Address - Country:US
Mailing Address - Phone:419-215-8350
Mailing Address - Fax:
Practice Address - Street 1:808 CONTINENTAL DR
Practice Address - Street 2:
Practice Address - City:WATERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43566-1204
Practice Address - Country:US
Practice Address - Phone:419-367-7718
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-03
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH488785163WN0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WN0002XNursing Service ProvidersRegistered NurseNeonatal Intensive Care