Healthcare Provider Details

I. General information

NPI: 1063178648
Provider Name (Legal Business Name): BRITTANY SPIVEY APN,DNP-FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/09/2021
Last Update Date: 11/09/2021
Certification Date: 11/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5041 UTICA RIDGE RD STE 100
DAVENPORT IA
52807-3480
US

IV. Provider business mailing address

545 VALLEY VIEW DR
MOLINE IL
61265-6138
US

V. Phone/Fax

Practice location:
  • Phone: 563-359-9696
  • Fax: 563-359-1730
Mailing address:
  • Phone: 309-762-5560
  • Fax: 309-277-1191

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberA166075
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: