Individual
MRS. PATRICIA D SPARKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
901 WASHINGTON STREET, PORTSMOUTH, OH 45662
(740) 354-7702
(740) 353-1662
Mailing address
PO BOX 1507, PORTSMOUTH, OH 45662
(740) 354-7702
(740) 353-1662
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN198778
OH
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
NP07420
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0200599
—
OH
05
—
2432666
—
OH
Enumeration date
12/05/2006
Last updated
08/14/2012
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