Healthcare Provider Details

I. General information

NPI: 1447773320
Provider Name (Legal Business Name): TRISHA A SPRAY APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2017
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 LONDON MOUNTAIN VIEW DR FL 1
LONDON KY
40741-6668
US

IV. Provider business mailing address

PO BOX 21890
BELFAST ME
04915-4115
US

V. Phone/Fax

Practice location:
  • Phone: 859-275-5229
  • Fax: 859-977-2683
Mailing address:
  • Phone: 502-907-0356
  • Fax: 502-919-9780

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3011304
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: