Individual
MS. JODY M SPROUL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
3350 BERKMAR DR, CHARLOTTESVILLE, VA 22901-1491
(434) 923-4651
(349) 643-6364
Mailing address
1180 RESURGENCE DR, STE 100, WATKINSVILLE, GA 30677-7211
(706) 543-5858
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN304309
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0024175956
STATE LICENSE
VA
Enumeration date
01/20/2016
Last updated
03/07/2023
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