Provider Demographics
NPI:1245627322
Name:SPANN, DAVIDA (FNP)
Entity type:Individual
Prefix:
First Name:DAVIDA
Middle Name:
Last Name:SPANN
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 1:2019 BELVEDERE CV
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35242-6637
Mailing Address - Country:US
Mailing Address - Phone:205-862-6240
Mailing Address - Fax:
Practice Address - Street 1:3700 CAHABA BEACH RD
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35242-5225
Practice Address - Country:US
Practice Address - Phone:205-421-2088
Practice Address - Fax:205-982-7882
Is Sole Proprietor?:No
Enumeration Date:2015-04-16
Last Update Date:2015-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-106106363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily