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Individual
MRS. LORETTA MARGARET SPARKMAN
Active
Individual
MRS. LORETTA MARGARET SPARKMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
CNP-02005
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000575565
—
NM
01
—
46-2684908
FEIN
NM
01
—
NMA102670
MEDICARE NUMBER
NM
Enumeration date
02/10/2012
Last updated
05/23/2013
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