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Individual
JACQUELYN MARIE SPANO
Active
Individual
JACQUELYN MARIE SPANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, NP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
17736
CA
363LP0200X
Pediatric Nurse Practitioner
NP17736
CA
363LP0222X
Critical Care Pediatric Nurse Practitioner
R 109517-3
MN
Other
Enumeration date
10/03/2006
Last updated
01/08/2021
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