Provider Demographics
NPI:1871302984
Name:SPONHALTZ, ROBIN SUE (LPN)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:SUE
Last Name:SPONHALTZ
Suffix:
Gender:
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 LOCUST LN
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIRSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43950-1568
Mailing Address - Country:US
Mailing Address - Phone:740-391-5515
Mailing Address - Fax:
Practice Address - Street 1:115 LOCUST LN
Practice Address - Street 2:
Practice Address - City:SAINT CLAIRSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43950-1568
Practice Address - Country:US
Practice Address - Phone:740-391-5515
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-03
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH124445164W00000X
OH347C00000X, 3747P1801X
OH124445.MEDS164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Single Specialty
No347C00000XTransportation ServicesPrivate Vehicle
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant