Provider Demographics
NPI:1457027682
Name:SPANOS, IRENE-MARGARETTE LOUIS (APRN)
Entity Type:Individual
Prefix:
First Name:IRENE-MARGARETTE
Middle Name:LOUIS
Last Name:SPANOS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1385 CLASSIC CT UNIT 345
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29466-7273
Mailing Address - Country:US
Mailing Address - Phone:860-941-5976
Mailing Address - Fax:
Practice Address - Street 1:101 SPRINGHALL DR
Practice Address - Street 2:
Practice Address - City:GOOSE CREEK
Practice Address - State:SC
Practice Address - Zip Code:29445-5336
Practice Address - Country:US
Practice Address - Phone:843-302-0920
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-18
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC25245363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily