Healthcare Provider Details

I. General information

NPI: 1750409082
Provider Name (Legal Business Name): PATTI SPERLING ARNP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2007
Last Update Date: 12/31/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

402 MYRTLEWOOD CIR
JACKSONVILLE NC
28546-7412
US

IV. Provider business mailing address

402 MYRTLEWOOD CIR
JACKSONVILLE NC
28546-7412
US

V. Phone/Fax

Practice location:
  • Phone: 910-989-2727
  • Fax: 910-989-2727
Mailing address:
  • Phone: 910-989-2727
  • Fax: 910-989-2727

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberARNP 9201189
License Number StateFL

VIII. Authorized Official

Name: MR. ARTHUR WALTER SPERLING
Title or Position: VP OPERATIONS
Credential:
Phone: 941-544-2207