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NPI Code Detail

MEDICARE: CHRISTEN DEANNE SPANO

MEDICARE: CHRISTEN DEANNE SPANO
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
1363L00000XNurse PractitionerRN150561GA

General Provider Information

NPI Number : 1326703158
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTEN DEANNE SPANO
Provider Business Mailing Address
First Line : 707 WASHBOARD RD
Second Line :
City : CLEVELAND
State : GA
Zip : 30528-7560
Country : US
Telephone Number : 678-982-4174
Fax Number :
Provider Business Practice Location Address
First Line : 2129 FRIENDSHIP RD
Second Line :
City : BUFORD
State : GA
Zip : 30519-2600
Country : US
Telephone Number : 770-209-2787
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/06/2021
Last Update Date : 11/06/2021

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Directions to “ CHRISTEN DEANNE SPANO ” Practice Location

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