Provider Demographics
NPI:1700013646
Name:SPENGLER, HEATHER BURKWHAT (RN)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:BURKWHAT
Last Name:SPENGLER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:618TH DENTAL CO (AS)
Mailing Address - Street 2:UNIT 15652 BOX 37
Mailing Address - City:APO
Mailing Address - State:AP
Mailing Address - Zip Code:96205-5652
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:618TH DENTAL CO (AS)
Practice Address - Street 2:UNIT 15652 BOX 37
Practice Address - City:APO
Practice Address - State:AP
Practice Address - Zip Code:96205-5652
Practice Address - Country:US
Practice Address - Phone:315-737-3101
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-18
Last Update Date:2009-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX724521286500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes286500000XHospitalsMilitary Hospital