Healthcare Provider Details

I. General information

NPI: 1174832505
Provider Name (Legal Business Name): AMY LUNELL SPOTANSKI CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/04/2010
Last Update Date: 06/05/2024
Certification Date: 06/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

559 VINCENT ST
COLORADO SPRINGS CO
80914-1541
US

IV. Provider business mailing address

559 VINCENT ST
PETERSON AFB CO
80914-1541
US

V. Phone/Fax

Practice location:
  • Phone: 937-257-0837
  • Fax:
Mailing address:
  • Phone: 210-846-4727
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number57156
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: