Provider Demographics
NPI:1831165752
Name:SPRAY, ANNE NICOLE (APRN)
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:NICOLE
Last Name:SPRAY
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:ANNE
Other - Middle Name:NICOLE
Other - Last Name:DEINES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:105 W 13TH ST
Mailing Address - Street 2:
Mailing Address - City:HAYS
Mailing Address - State:KS
Mailing Address - Zip Code:67601-3613
Mailing Address - Country:US
Mailing Address - Phone:785-621-4990
Mailing Address - Fax:
Practice Address - Street 1:105 W 13TH ST
Practice Address - Street 2:
Practice Address - City:HAYS
Practice Address - State:KS
Practice Address - Zip Code:67601-3613
Practice Address - Country:US
Practice Address - Phone:785-621-4990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-28
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS44880363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100345360CMedicaid
KS100345360CMedicaid
KSP04732Medicare UPIN