Provider Demographics
NPI:1710986617
Name:SPALDING, MARSHA R (FNP)
Entity Type:Individual
Prefix:
First Name:MARSHA
Middle Name:R
Last Name:SPALDING
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 MULBERRY ST
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47713-1252
Mailing Address - Country:US
Mailing Address - Phone:812-421-7489
Mailing Address - Fax:812-421-7497
Practice Address - Street 1:315 MULBERRY ST
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47713-1252
Practice Address - Country:US
Practice Address - Phone:812-421-7489
Practice Address - Fax:812-421-7497
Is Sole Proprietor?:No
Enumeration Date:2005-07-21
Last Update Date:2021-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71001454A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200469410Medicaid
IN000000329398OtherANTHEM BCBS
IN200079040BOtherMEDICAID GRP
IN200469410Medicaid
IN637650NMedicare ID - Type Unspecified