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Individual

ANN K SPAULDING

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
12101 CAROL LN, FREDERICKSBURG, VA 22407-6101
(540) 785-7815
(540) 786-8620
Mailing address
PO BOX 1460, FREDERICKSBURG, VA 22402-1460
(540) 786-2100
(540) 786-6673

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110840747
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
010370710
VA
01
01110840747
MEDICAL LICENSE
VA
01
C02375
MEDICARE GROUP
VA
Enumeration date
12/12/2006
Last updated
09/03/2014
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