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Individual

SHARON L SPEAR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
5010 W JEFFERSON BLVD, FORT WAYNE, IN 46804-6804
(260) 436-1248
(260) 436-7968
Mailing address
5010 W JEFFERSON BLVD, FORT WAYNE, IN 46804-6804
(260) 436-1248
(260) 436-7968

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
71004075A
IN
363LA2200X
Adult Health Nurse Practitioner
71004075B
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
71004075
LICENSE
IN
Enumeration date
06/26/2013
Last updated
06/26/2013
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