Provider Demographics
NPI:1770874158
Name:SPRING, ROSEMARY PATRICIA (APN)
Entity type:Individual
Prefix:
First Name:ROSEMARY
Middle Name:PATRICIA
Last Name:SPRING
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:52450 RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:TALIHINA
Mailing Address - State:OK
Mailing Address - Zip Code:74571-1408
Mailing Address - Country:US
Mailing Address - Phone:479-243-4993
Mailing Address - Fax:
Practice Address - Street 1:12300 HIGHWAY 71 S STE A
Practice Address - Street 2:
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72916-9474
Practice Address - Country:US
Practice Address - Phone:479-755-6595
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-20
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA03538363LG0600X
OKR 72800363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARA03538OtherAPN LICENSE