Spain, Maureen A
Spain, Maureen A is an individual health care provider with primary practice located at 8626 Airways Blvd , Southaven MS 38671-2603. She recently has 3 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, Physician Assistants & Advanced Practice Nursing Providers / Neonatal. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health is her primary health care specialty. Spain, Maureen A can be contacted via phone (662) 772-5937.Contact Information
Primary practice address
8626 Airways Blvd
Southaven MS 38671-2603
Phone: (662) 772-5937
Fax: (662) 772-5940
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner | 363L00000X | APN7656 | Tennessee |
| Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health | 363LP0808X | 000196 | Mississippi |
| Physician Assistants & Advanced Practice Nursing Providers / Neonatal | 363LN0000X | 2009034350 | Missouri |
| Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health | 363LP0808X | 7656 | Tennessee |
| Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health | 363LP0808X | 184206 | Montana |
Profile Details
| NPI number | 1194770024 |
|---|---|
| LBN Legal business name | Spain, Maureen A |
| Credentials | Nurse Practitioner (NP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 22nd, 2006 |
| Last updated | Dec 6th, 2021 - about 3 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1194770024 | NPPES |
| Mississippi | Other | NA | SUBMITTING CREDENTIALING APPLICATIONS CURRENTLY |
| Mississippi | MEDICAID | 3495342 | SUBMITTING CREDENTIALING APPLICATIONS CURRENTLY |
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