MEDICARE: MS. JAIME SPINELLA RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	734938-01	NY
2	367500000X	Certified Registered Nurse Anesthetist	0024190599	VA

General Provider Information

NPI Number	:	1568192441
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JAIME SPINELLA RN

Provider Business Mailing Address
First Line	:	3918 MONUMENT AVE
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23230-3902
Country	:	US
Telephone Number	:	732-547-1537
Fax Number	:

Provider Business Practice Location Address
First Line	:	3918 MONUMENT AVE
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23230-3902
Country	:	US
Telephone Number	:	732-547-1537
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/14/2022
Last Update Date	:	08/15/2024

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