Provider Demographics
NPI:1093145922
Name:SPILLMAN, NANCEE RAE (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:NANCEE
Middle Name:RAE
Last Name:SPILLMAN
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:NANCEE
Other - Middle Name:RAE
Other - Last Name:YAGGIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 766351
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-6351
Mailing Address - Country:US
Mailing Address - Phone:502-588-9490
Mailing Address - Fax:502-272-5116
Practice Address - Street 1:315 E BROADWAY
Practice Address - Street 2:SUITE 104
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-3700
Practice Address - Country:US
Practice Address - Phone:502-629-8990
Practice Address - Fax:502-394-3604
Is Sole Proprietor?:No
Enumeration Date:2013-11-13
Last Update Date:2021-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3008293363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner