Tequilla Marie Sprewer

Primary specialty

Home Health AideTaxonomy code 374U00000X

License

99614 Issued in AZ

Practice address

12170 W Joblanca Rd
Avondale, AZ 85323-8179

Phone

(414) 324-0220

NPI assigned

Jun 29, 2021

Last updated

Jun 30, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1624924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625011200000",
    "number": "1710557905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12170 W JOBLANCA RD",
            "city": "AVONDALE",
            "state": "AZ",
            "postal_code": "853238179",
            "telephone_number": "414-324-0220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12170 W JOBLANCA RD",
            "city": "AVONDALE",
            "state": "AZ",
            "postal_code": "853238179",
            "telephone_number": "414-324-0220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPREWER",
        "first_name": "TEQUILLA",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-29",
        "last_updated": "2021-06-30",
        "certification_date": "2021-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "AZ",
            "license": "99614",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Spirit-Mind-Body Healthcare PLLC (Spirit-Mind-Body Behavioral Health)
• Aaron Michael Spivey, PT
• Spooner Physical Therapy & Hand Rehab, PC (Spooner Avondale)
• Spooner Rehab, PC
• Amanda Kalyca Sprague, PA-C
• Springs of Joy LLC.
• Bonifasiyo K. Ssennyamantono, MD
• Carol St. Jean Brisebois, SLPA
• Emily W Stafford, DPT
• Jessica Stafford

• Home Health Aide in Avondale, AZ
• Providers in Avondale, AZ by specialty
• Home Health Aide in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.