MEDICARE: FALLYN HOPE SPINKS

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
1	1710I1003X	Independent Duty Medical Technicians

General Provider Information

NPI Number	:	1184500928
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FALLYN HOPE SPINKS

Provider Business Mailing Address
First Line	:	164 CLARK POINT RD
Second Line	:
City	:	SOUTHWEST HARBOR
State	:	ME
Zip	:	04679-4414
Country	:	US
Telephone Number	:	718-300-2176
Fax Number	:

Provider Business Practice Location Address
First Line	:	184 CLARK POINT RD
Second Line	:
City	:	SOUTHWEST HARBOR
State	:	ME
Zip	:	04679-4414
Country	:	US
Telephone Number	:	718-300-2176
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/15/2025
Last Update Date	:	08/15/2025

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Directions to “ FALLYN HOPE SPINKS ” Practice Location

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