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Individual

BRANDEA R SPARKS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
AGPCNP

Contact information

Practice address
2872 TURNPIKE ST, SUSQUEHANNA, PA 18847-2771
(570) 853-3135
Mailing address
2872 TURNPIKE ST, SUSQUEHANNA, PA 18847-2771
(570) 853-3135

Taxonomy

Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
SP015005
PA

Other

Enumeration date
06/18/2015
Last updated
06/18/2015
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