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General NPI Number Information
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NPI Number | 1780167809
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Entity Type | Individual
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Provider Name | NICOLE ANN SPALL APRN-BC
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Gender | Female
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Dates
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Enumeration Date | 09/13/2018
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Last Update Date | 10/07/2025
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Provider Practice Location Address
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Address Line | 1507 S TUTTLE AVE
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City | SARASOTA
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State | FL
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Zip | 34239-2608
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Country | US
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Telephone | 301-722-0484
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Fax | 833-903-0130
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Provider Business Mailing Address
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Address Line | 157 BALTIMORE ST STE 102
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City | CUMBERLAND
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State | MD
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Zip | 21502-2472
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Country | US
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Telephone | 301-722-0148
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Fax | 833-903-0130
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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 | ARNP9287830
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | APRN9287830
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License Number State | FL
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