Healthcare Provider Details

I. General information

NPI: 1477909075
Provider Name (Legal Business Name): CARMENCITA LESLIE SPRADLING FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2016
Last Update Date: 09/03/2021
Certification Date: 09/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5950 SARATOGA BLVD
CORPUS CHRISTI TX
78414-4100
US

IV. Provider business mailing address

6181 SARATOGA BLVD UNIT 117
CORPUS CHRISTI TX
78414-2475
US

V. Phone/Fax

Practice location:
  • Phone: 361-985-5811
  • Fax:
Mailing address:
  • Phone: 361-444-5148
  • Fax: 361-444-5495

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP131063
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: