MEDICARE: ROSEMARY PATRICIA SPRING APN

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	363LG0600X	Gerontology Nurse Practitioner	A03538	AR
2	363LG0600X	Gerontology Nurse Practitioner	R 72800	OK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	A03538	OTHER	AR	APN LICENSE

General Provider Information

NPI Number	:	1770874158
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROSEMARY PATRICIA SPRING APN

Provider Business Mailing Address
First Line	:	52450 RIDGE RD
Second Line	:
City	:	TALIHINA
State	:	OK
Zip	:	74571-1408
Country	:	US
Telephone Number	:	479-243-4993
Fax Number	:

Provider Business Practice Location Address
First Line	:	12300 HIGHWAY 71 S STE A
Second Line	:
City	:	FORT SMITH
State	:	AR
Zip	:	72916-9474
Country	:	US
Telephone Number	:	479-755-6595
Fax Number	:

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

Provider Enumeration Date	:	04/20/2011
Last Update Date	:	03/17/2018

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