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General NPI Number Information
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NPI Number | 1609687391
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Entity Type | Individual
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Provider Name | KATIE SPARKS CNS
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Gender | Female
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Dates
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Enumeration Date | 01/14/2025
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Last Update Date | 01/14/2025
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Provider Practice Location Address
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Address Line | 201 E GROVER ST
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City | SHELBY
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State | NC
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Zip | 28150-3917
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Country | US
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Telephone | 980-487-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 4728 PEYTON PL
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City | SHELBY
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State | NC
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Zip | 28150-9375
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Country | US
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Telephone | 704-692-8444
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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 | 364SA2100X
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Taxonomy Name | Acute Care Clinical Nurse Specialist
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License Number | 574
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License Number State | NC
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