MEDICARE: MS. MABLE R. SPELL ARNP

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	363L00000X	Nurse Practitioner	255P	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1801857065
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MABLE R. SPELL ARNP

Provider Business Mailing Address
First Line	:	PO BOX 1125
Second Line	:
City	:	CORBIN
State	:	KY
Zip	:	40702-1125
Country	:	US
Telephone Number	:	606-528-0283
Fax Number	:	606-528-8422

Provider Business Practice Location Address
First Line	:	2734 S HIGHWAY 421
Second Line	:
City	:	MANCHESTER
State	:	KY
Zip	:	40962-7515
Country	:	US
Telephone Number	:	606-599-0609
Fax Number	:	606-599-8419

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

Provider Enumeration Date	:	03/29/2006
Last Update Date	:	02/08/2026

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