Provider Demographics
NPI:1861129157
Name:SPANGLER, JESSICA (NURSE PRACTITIONER)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:SPANGLER
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25483 CALDERA DR
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:AL
Mailing Address - Zip Code:35613-8334
Mailing Address - Country:US
Mailing Address - Phone:251-776-4035
Mailing Address - Fax:251-776-4035
Practice Address - Street 1:25483 CALDERA DR
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:AL
Practice Address - Zip Code:35613-8334
Practice Address - Country:US
Practice Address - Phone:251-776-4035
Practice Address - Fax:251-776-4035
Is Sole Proprietor?:No
Enumeration Date:2022-08-05
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-152290207V00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology