Doctor Name: | JOHN T SPANNUTH |
NPI Number: | 1053668707 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | FNP |
License Number: | 041.338786 |
Business Practice Address: | 1 Boone Road Naval Hospital Bremerton, WA - 98312 |
Business Phone Number: | 3604754379 |
Business Fax Number: | 3604754646 |
Mailing Address: | 1 Boone Road, Naval Hospital BREMERTON |
State: | WA |
Postal Code: | 98312 |
Phone Number: | 3604754379 |
Fax Number: | 3604754646 |
NPI Enumeration Date: | 08/13/2012 |
NPI Last Update Date: | 08/13/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 041.338786 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |