Individual
CASSANDRA E SPRUILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
1235 E CHEROKEE ST, SPRINGFIELD, MO 65804-2203
(417) 820-6569
Mailing address
1235 E CHEROKEE ST, SPRINGFIELD, MO 65804-2203
(417) 820-6569
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
835491
TX
363L00000X
Nurse Practitioner
835491
TX
363LA2200X
Adult Health Nurse Practitioner
20736
TN
363LF0000X
Family Nurse Practitioner
Primary
2020010589
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00106W
MDCR GRP PTAN
TX
01
—
153449704
MDCD GRP TPI
TX
01
—
DB6392
RR MDCR GRP PROV #
TX
Enumeration date
10/24/2008
Last updated
02/27/2024
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