Basic Information
| Provider Information | |||||||||
| NPI: | 1619365178 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SPELLMAN | ||||||||
| FirstName: | RITA | ||||||||
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| Credential: | FNP-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4030 POPLAR DR | ||||||||
| Address2: | |||||||||
| City: | WHITESTOWN | ||||||||
| State: | IN | ||||||||
| PostalCode: | 460759819 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3176942150 | ||||||||
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| Practice Location | |||||||||
| Address1: | 207 S LEBANON ST | ||||||||
| Address2: | |||||||||
| City: | LEBANON | ||||||||
| State: | IN | ||||||||
| PostalCode: | 460522544 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7654823630 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/06/2015 | ||||||||
| LastUpdateDate: | 08/19/2016 | ||||||||
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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 | 363LF0000X | 28132158A | IN | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.