Provider Demographics
NPI:1023375383
Name:SPROKKREEFF, ONICA (CDM)
Entity type:Individual
Prefix:MS
First Name:ONICA
Middle Name:
Last Name:SPROKKREEFF
Suffix:
Gender:F
Credentials:CDM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7200 E VALLEY CIR
Mailing Address - Street 2:SUITE #6
Mailing Address - City:PALMER
Mailing Address - State:AK
Mailing Address - Zip Code:99645-5929
Mailing Address - Country:US
Mailing Address - Phone:907-746-6644
Mailing Address - Fax:186-689-6140
Practice Address - Street 1:7200 E VALLEY CIR
Practice Address - Street 2:SUITE #6
Practice Address - City:PALMER
Practice Address - State:AK
Practice Address - Zip Code:99645-5929
Practice Address - Country:US
Practice Address - Phone:907-746-6644
Practice Address - Fax:186-689-6140
Is Sole Proprietor?:No
Enumeration Date:2012-04-11
Last Update Date:2012-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK71176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife