Spain, Ketty M

Spain, Ketty M is an individual health care provider with primary practice located at 514 W Atlantic St , South Hill VA 23970-1906. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Spain, Ketty M can be contacted via phone (434) 584-2000.

Contact Information

Primary practice address
514 W Atlantic St South Hill VA 23970-1906
Phone: (434) 584-2000
Fax: (434) 447-2240
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 0024167836 Virginia
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 0024167836 Virginia
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 5006092 North Carolina

Profile Details

NPI number 1427225846
LBN Legal business name Spain, Ketty M
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date May 14th, 2008
Last updated Jan 13th, 2017 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1427225846 NPPES
Virginia MEDICAID 1427225846

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