Provider Demographics
NPI:1851990428
Name:SPELLMAN, KATHERINE RITA (RN)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:RITA
Last Name:SPELLMAN
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:PO BOX 414
Mailing Address - Street 2:
Mailing Address - City:HALLSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75650-0414
Mailing Address - Country:US
Mailing Address - Phone:903-238-3943
Mailing Address - Fax:
Practice Address - Street 1:411 N CENTRAL ST SUITE 414
Practice Address - Street 2:
Practice Address - City:HALLSVILLE
Practice Address - State:TX
Practice Address - Zip Code:75650-0414
Practice Address - Country:US
Practice Address - Phone:903-238-3943
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-23
Last Update Date:2020-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1008988163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse