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Individual

TAMALA S. SPARKS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNP

Contact information

Practice address
1020 TUSCALOOSA AVE, GADSDEN, AL 35901-3005
(256) 546-4606
Mailing address
3643 LAKEFRONT DR, SOUTHSIDE, AL 35907-0540
(256) 613-1101

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1-070362
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
165014 (ANNISTON)
AL
05
165246
AL
Enumeration date
08/29/2007
Last updated
12/23/2014
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