Provider Demographics
NPI:1164030045
Name:MITCHELL-SPRUAL, MARVA (NP-C)
Entity type:Individual
Prefix:
First Name:MARVA
Middle Name:
Last Name:MITCHELL-SPRUAL
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 UNIVERSITY PLZ STE 204
Mailing Address - Street 2:
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-6211
Mailing Address - Country:US
Mailing Address - Phone:973-241-1356
Mailing Address - Fax:201-490-9133
Practice Address - Street 1:2 UNIVERSITY PLZ STE 204
Practice Address - Street 2:
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-6211
Practice Address - Country:US
Practice Address - Phone:973-241-1356
Practice Address - Fax:201-490-9133
Is Sole Proprietor?:No
Enumeration Date:2020-07-16
Last Update Date:2025-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ01047400363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily