MEDICARE: NICHOLE R SPAID

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	124Q00000X	Dental Hygienist	DH043436	GA

General Provider Information

NPI Number	:	1811477953
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICHOLE R SPAID

Provider Business Mailing Address
First Line	:	8465 BLACKHORSE ST
Second Line	:
City	:	FORT BENNING
State	:	GA
Zip	:	31905-7038
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8465 BLACKHORSE ST
Second Line	:
City	:	FORT BENNING
State	:	GA
Zip	:	31905-7038
Country	:	US
Telephone Number	:	785-375-4131
Fax Number	:

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

Provider Enumeration Date	:	08/17/2018
Last Update Date	:	08/17/2018

Similar Medicare Providers

1184127060 — RAYSHAD WITHROW OTR
Practice Location Address:

1015 DEERBROOK DR APT 1724
FORT WORTH, TX
76108-7038

Practice Phone: 682-249-9820
Practice Fax:

1144811019 — MELISSA CRUZ
Practice Location Address:

2018 FORT BRAGG RD STE 112B
FAYETTEVILLE, NC
28303-7038

Practice Phone: 910-920-0181
Practice Fax:

1043049208 — CREATORS MIND CARES4US
Practice Location Address:

1074 S ERIE ST
FORT WORTH, TX
76112-7038

Practice Phone: 325-232-4205
Practice Fax:

1295277754 — MS. DELPHINE SITSOFE AYIVOR
Practice Location Address:

6600 VAN AALST BLVD
FORT BENNING, GA
31905-2102

Practice Phone: 706-626-1703
Practice Fax:

1386173961 — DR. RANDALL WILLIAM SIDES PT
Practice Location Address:

6600 VAN AALST BLVD BLDG 9250
FORT BENNING, GA
31905-2102

Practice Phone: 850-945-6643
Practice Fax:

1073460481 — CESAR SERGIO REYES II
Practice Location Address:

6600 VAN AALST BLVD
FORT BENNING, GA
31905-2102

Practice Phone: 762-408-2613
Practice Fax:

Directions to “ NICHOLE R SPAID ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.