Provider Demographics
NPI:1962689745
Name:SPEARS, NICKIE (MD)
Entity Type:Individual
Prefix:DR
First Name:NICKIE
Middle Name:
Last Name:SPEARS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1241 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22802-4632
Mailing Address - Country:US
Mailing Address - Phone:540-434-1941
Mailing Address - Fax:540-434-0132
Practice Address - Street 1:1241 N MAIN ST
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22802
Practice Address - Country:US
Practice Address - Phone:540-434-1941
Practice Address - Fax:540-434-0132
Is Sole Proprietor?:No
Enumeration Date:2008-01-24
Last Update Date:2020-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01010458272084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry