Provider Demographics
NPI:1649933953
Name:SPINK, MEREDITH MIKA (FNP-BC)
Entity type:Individual
Prefix:
First Name:MEREDITH
Middle Name:MIKA
Last Name:SPINK
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:504 SOUTHINGTON CT
Mailing Address - Street 2:
Mailing Address - City:GREER
Mailing Address - State:SC
Mailing Address - Zip Code:29650-4675
Mailing Address - Country:US
Mailing Address - Phone:180-398-4211
Mailing Address - Fax:
Practice Address - Street 1:2210 LAURENS RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-3224
Practice Address - Country:US
Practice Address - Phone:864-288-8280
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-14
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC25553363LF0000X
SC101952163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse