Shannon Rae Spradlin, LPN

Individual provider Active NPI Licensed Practical Nurse · Davis, IL

NPI 1003104449 · NPPES record last updated Jul 19, 2011

Key facts

NPI
1003104449
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
305838-031 (WI)
Practice address
346 Corkhill CT
Davis, IL 61019-9519
Phone
(815) 520-3789
NPI assigned
Jul 19, 2011
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
305838-031WIMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 305838-031 WI Yes

Addresses

Primary practice location

346 Corkhill CT
Davis, IL 61019-9519

Mailing address

346 Corkhill CT
Davis, IL 61019-9519
Phone (815) 520-3789

Other names

  • Shannon Rae Finch Former name

Other providers in Davis, IL

All providers in Davis, IL · Licensed Practical Nurse in Illinois

Sources for this page

Verify at the official NPI Registry.