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General NPI Number Information
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NPI Number | 1992887996
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Entity Type | Individual
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Provider Name | MONITA SPANN CSFA
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Gender | Female
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Dates
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Enumeration Date | 10/19/2006
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Last Update Date | 10/01/2014
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Provider Practice Location Address
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Address Line | 7001 ROGERS AVE SUITE 401
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City | FORT SMITH
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State | AR
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Zip | 72903-4073
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Country | US
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Telephone | 479-452-1188
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Fax | 479-452-1196
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Provider Business Mailing Address
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Address Line | 11023 HUNTERS POINT RD
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City | FORT SMITH
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State | AR
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Zip | 72903-5846
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Country | US
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Telephone | 918-688-9171
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Fax | 479-223-3369
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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 | 246ZS0410X
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Taxonomy Name | Surgical Technologist
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License Number | F01335
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 246ZC0007X
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Taxonomy Name | Surgical Assistant
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License Number | F01335
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License Number State | OK
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