Individual
MRS. DARICE R SPACKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC ATC
Contact information
Practice address
330 22ND AVE N, NASHVILLE, TN 37203-1844
(615) 320-0007
(615) 320-0009
Mailing address
330 22ND AVE N, NASHVILLE, TN 37203-1844
(615) 320-0007
(615) 320-0009
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA 949
TN
363AS0400X
Surgical Physician Assistant
949
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1504589
—
TN
01
—
4166893
BCBS
TN
01
—
4193033
BCBS ASSISTANT AT SURGERY
TN
Enumeration date
11/14/2005
Last updated
01/23/2015
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