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General NPI Number Information
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NPI Number | 1457027682
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Entity Type | Individual
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Provider Name | IRENE-MARGARETTE LOUIS SPANOS APRN
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Gender | Female
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Dates
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Enumeration Date | 08/18/2021
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Last Update Date | 08/18/2021
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Provider Practice Location Address
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Address Line | 101 SPRINGHALL DR
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City | GOOSE CREEK
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State | SC
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Zip | 29445-5336
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Country | US
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Telephone | 843-302-0920
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Fax |
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Provider Business Mailing Address
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Address Line | 1385 CLASSIC CT UNIT 345
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City | MOUNT PLEASANT
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State | SC
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Zip | 29466-7273
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Country | US
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Telephone | 860-941-5976
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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 | 25245
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License Number State | SC
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