MEDICARE: MR. DAMON SCOTT SPEARS RN,MSN, 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
1	163W00000X	Registered Nurse	R852829	MS
2	163WE0003X	Emergency Registered Nurse	R852829	MS
3	163WF0300X	Flight Registered Nurse	R852829	MS
4	163WU0100X	Urology Registered Nurse	R852829	MS
5	363L00000X	Nurse Practitioner	901999	MS

General Provider Information

NPI Number	:	1679628697
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DAMON SCOTT SPEARS RN,MSN, FNP-C

Provider Business Mailing Address
First Line	:	701B ROBB ST
Second Line	:
City	:	SUMMIT
State	:	MS
Zip	:	39666-8241
Country	:	US
Telephone Number	:	601-608-0900
Fax Number	:

Provider Business Practice Location Address
First Line	:	804 ROBB ST
Second Line	:
City	:	SUMMIT
State	:	MS
Zip	:	39666-8291
Country	:	US
Telephone Number	:	601-608-0900
Fax Number	:	601-600-2171

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

Provider Enumeration Date	:	01/23/2007
Last Update Date	:	04/30/2025

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Directions to “ MR. DAMON SCOTT SPEARS RN,MSN, FNP-C” Practice Location

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