Basic Information
| Provider Information | |||||||||
| NPI: | 1255472130 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SPAIN | ||||||||
| FirstName: | RENEE | ||||||||
| MiddleName: | OAKLEY | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | CNM | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1275 MACS LN | ||||||||
| Address2: | |||||||||
| City: | GREENVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 278347450 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2529022300 | ||||||||
| FaxNumber: | 2524131433 | ||||||||
| Practice Location | |||||||||
| Address1: | EAST CAROLINA UNIVERSITY SCHOOL OF NURSING | ||||||||
| Address2: | NURS-ALLIED HLTH BLDG, WEST CAMPUS | ||||||||
| City: | GREENVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 27834 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2527440000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/12/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367A00000X | 280 | NC | Y | Physician Assistants & Advanced Practice Nursing Providers | Advanced Practice Midwife |
No ID Information.