Provider Demographics
NPI:1548277858
Name:SPINNER, GERALD (FNP)
Entity type:Individual
Prefix:MR
First Name:GERALD
Middle Name:
Last Name:SPINNER
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 860
Mailing Address - Street 2:IHS INDIAN HEALTH HOSPITAL
Mailing Address - City:WHITERIVER
Mailing Address - State:AZ
Mailing Address - Zip Code:85941-0860
Mailing Address - Country:US
Mailing Address - Phone:928-338-4911
Mailing Address - Fax:
Practice Address - Street 1:200 W. HOSPITAL DR.
Practice Address - Street 2:INDIAN HEALTH HOSPITAL
Practice Address - City:WHITERIVER
Practice Address - State:AZ
Practice Address - Zip Code:85941-0860
Practice Address - Country:US
Practice Address - Phone:928-338-4911
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2013-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP2638363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ1295993376Medicaid
AZ486416Medicaid
AZ1871523191Medicaid
AZ1780614008Medicaid
AZ1629236716Medicaid
AZ1629236716Medicaid
AZ1295993376Medicaid
AZ1871523191Medicaid