Individual
JENNIFER MARIE SPONAUGLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
800 ROSE ST ROACH CANCER CTR 1ST FL, LEXINGTON, KY 40536-2100
(859) 257-6006
(859) 257-6002
Mailing address
6071W OUTER DR, DETROIT, MI 48235-2624
(313) 966-1003
(313) 966-1738
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
5601007029
MI
363A00000X
Physician Assistant
Primary
PA3627
KY
363AM0700X
Medical Physician Assistant
PA3627
KY
363AS0400X
Surgical Physician Assistant
PA3627
KY
Other
Enumeration date
05/27/2014
Last updated
07/01/2025
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