Provider Demographics
NPI:1255472130
Name:SPAIN, RENEE OAKLEY (CNM)
Entity Type:Individual
Prefix:MRS
First Name:RENEE
Middle Name:OAKLEY
Last Name:SPAIN
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1275 MACS LN
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-7450
Mailing Address - Country:US
Mailing Address - Phone:252-902-2300
Mailing Address - Fax:252-413-1433
Practice Address - Street 1:EAST CAROLINA UNIVERSITY SCHOOL OF NURSING
Practice Address - Street 2:NURS-ALLIED HLTH BLDG, WEST CAMPUS
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834
Practice Address - Country:US
Practice Address - Phone:252-744-0000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC280367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCP35461Medicare UPIN