Provider Demographics
NPI:1851870323
Name:SPERZEL, CARLY ROSE (DNP, APRN)
Entity Type:Individual
Prefix:DR
First Name:CARLY
Middle Name:ROSE
Last Name:SPERZEL
Suffix:
Gender:F
Credentials:DNP, APRN
Other - Prefix:
Other - First Name:CARLY
Other - Middle Name:R
Other - Last Name:OLIVER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 776879
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-6879
Mailing Address - Country:US
Mailing Address - Phone:502-588-9490
Mailing Address - Fax:502-272-5116
Practice Address - Street 1:2051 CLEVIDENCE BLVD STE C
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47129-2278
Practice Address - Country:US
Practice Address - Phone:812-280-6623
Practice Address - Fax:812-280-6632
Is Sole Proprietor?:No
Enumeration Date:2018-08-07
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3012307363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics