Individual
MRS. AUTUMN JADE SPELLMEIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
106 WILLOW RD, GOODLAND, KS 67735-1518
(785) 890-6075
(785) 890-6077
Mailing address
106 WILLOW RD, GOODLAND, KS 67735-1518
(785) 890-4012
(785) 890-6077
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
53-76843-091
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1982087631
BCBS
KS
05
—
201118440A
—
KS
Enumeration date
06/30/2015
Last updated
05/08/2017
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