| Doctor Name: | JACQUELINE SPANO |
| NPI Number: | 1083752893 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP |
| License Number: | 003535 |
| Business Practice Address: | 323 Cromwell Ave Rocky Hill, CT - 060671801 |
| Business Phone Number: | 8663892727 |
| Business Fax Number: | 4016529787 |
| Mailing Address: | 154 Moritz Pl, FAIRFIELD |
| State: | CT |
| Postal Code: | 068243528 |
| Phone Number: | 2032558194 |
| Fax Number: | |
| NPI Enumeration Date: | 02/02/2007 |
| NPI Last Update Date: | 05/03/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 003535 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CT |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |