Provider Demographics
NPI:1801806682
Name:SPANNRING, JOAN MARIE (APRN)
Entity type:Individual
Prefix:MS
First Name:JOAN
Middle Name:MARIE
Last Name:SPANNRING
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:931 HIGHLAND BLVD STE 3330
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59715-6912
Mailing Address - Country:US
Mailing Address - Phone:406-587-5533
Mailing Address - Fax:
Practice Address - Street 1:931 HIGHLAND BLVD STE 3330
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715-6912
Practice Address - Country:US
Practice Address - Phone:406-587-5533
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2018-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT15392363L00000X
MT100077363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00302105OtherMEDICARE RAILROAD
000374570OtherBCBS MT
MT4304599Medicaid