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NPI Code Detail

MEDICARE: CHARLES S SPEIR APRN, BC

MEDICARE: CHARLES S SPEIR APRN, BC
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 PractitionerRN054791GA

General Provider Information

NPI Number : 1720135890
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHARLES S SPEIR APRN, BC
Provider Business Mailing Address
First Line : PO BOX 897
Second Line :
City : LAWRENCEVILLE
State : GA
Zip : 30046-0897
Country : US
Telephone Number : 770-339-4260
Fax Number :
Provider Business Practice Location Address
First Line : 15 S CLAYTON ST
Second Line :
City : LAWRENCEVILLE
State : GA
Zip : 30045-5715
Country : US
Telephone Number : 770-339-4283
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/04/2007
Last Update Date : 07/08/2007

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Directions to “ CHARLES S SPEIR APRN, BC” Practice Location

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