Provider Demographics
NPI:1386639862
Name:SPINDT, ARACELIS M I (PA-C)
Entity Type:Individual
Prefix:
First Name:ARACELIS
Middle Name:M
Last Name:SPINDT
Suffix:I
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:237 WISCONSIN AVE
Mailing Address - Street 2:
Mailing Address - City:WAUKESHA
Mailing Address - State:WI
Mailing Address - Zip Code:53186-4955
Mailing Address - Country:US
Mailing Address - Phone:262-542-6324
Mailing Address - Fax:
Practice Address - Street 1:237 WISCONSIN AVE
Practice Address - Street 2:
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53186-4955
Practice Address - Country:US
Practice Address - Phone:262-542-6324
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI887-023363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI41959100Medicaid
WI41959100Medicaid