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NPI Code Detail

MEDICARE: ASHLEY N SPARKS FNP-C

MEDICARE: ASHLEY N SPARKS FNP-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner71004970AIN

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P01347741OTHERINMEDICARE RR PTAN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2IN3249010OTHERPTAN
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1114179900
Entity Type Code : Individual
Provider Name (Legal Business Name) : ASHLEY N SPARKS FNP-C
Provider Business Mailing Address
First Line : 821 N STATE ROAD 135
Second Line :
City : GREENWOOD
State : IN
Zip : 46142-1314
Country : US
Telephone Number : 317-560-4300
Fax Number : 317-530-9084
Provider Business Practice Location Address
First Line : 821 N STATE ROAD 135
Second Line :
City : GREENWOOD
State : IN
Zip : 46142-1314
Country : US
Telephone Number : 317-560-4300
Fax Number : 317-530-9084
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/13/2008
Last Update Date : 04/05/2022

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Directions to “ ASHLEY N SPARKS FNP-C” Practice Location

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