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General NPI Number Information
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NPI Number | 1134673015
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Entity Type | Individual
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Provider Name | MISTY LYNN SPRADLIN APRN
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Gender | Female
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Dates
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Enumeration Date | 08/09/2016
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Last Update Date | 11/19/2021
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Provider Practice Location Address
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Address Line | 617 23RD ST STE 8B
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City | ASHLAND
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State | KY
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Zip | 41101-2845
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Country | US
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Telephone | 606-408-1290
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Fax | 606-408-6640
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Provider Business Mailing Address
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Address Line | PO BOX 2379
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City | ASHLAND
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State | KY
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Zip | 41105-2379
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Country | US
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Telephone | 606-408-6200
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN74130-NP-C
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License Number State | WV
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 3011627
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License Number State | KY
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