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General NPI Number Information
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NPI Number | 1447628862
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Entity Type | Organization
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Legal Business Name | TINA SPOHN-LEDFORD FAMILY PRACTICE CLINIC
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Dates
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Enumeration Date | 09/02/2015
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Last Update Date | 09/02/2015
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Provider Practice Location Address
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Address Line | 713 N TAYLOR ST
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City | AMARILLO
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State | TX
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Zip | 79107-5279
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Country | US
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Telephone | 806-206-7625
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Fax |
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Provider Business Mailing Address
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Address Line | 713 N TAYLOR ST
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City | AMARILLO
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State | TX
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Zip | 79107-5279
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Country | US
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Telephone | 806-206-7625
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Fax |
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Authorized Official
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Title or Position | FAMILY NURSE PRACTITIONER
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Name | MRS. TINA JEANETTE SPOHN-LEDFORD
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Credential | APRN, FNP-BC
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Telephone | 806-206-7625
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | AP128944
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License Number State | TX
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