Brandea R Sparks, AGPCNP

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

SP015005 Issued in PA

Practice address

2872 Turnpike St
Susquehanna, PA 18847-2771

Phone

(570) 853-3135

NPI assigned

Jun 18, 2015

Last updated

Jun 18, 2015By 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)

Enrolled

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

{
    "created_epoch": "1434585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434585600000",
    "number": "1780066423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2872 TURNPIKE ST",
            "city": "SUSQUEHANNA",
            "state": "PA",
            "postal_code": "188472771",
            "telephone_number": "570-853-3135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2872 TURNPIKE ST",
            "city": "SUSQUEHANNA",
            "state": "PA",
            "postal_code": "188472771",
            "telephone_number": "570-853-3135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPARKS",
        "first_name": "BRANDEA",
        "middle_name": "R",
        "credential": "AGPCNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-18",
        "last_updated": "2015-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "PA",
            "license": "SP015005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathleen Reddon, PHARMACIS
• Julie Aileen Rowe, L.AC
• Jesse Santarelli, BS, PTA
• Mahendra K. Shah, MD
• Margaret Smith, MS CRNP
• Nicole Ann Suhadolnik, FNP-C
• Susquehanna Community School District
• Susquehanna Family Pharmacy LLC
• Susquehanna Fire Department Inc
• Trehab

• Primary Care Nurse Practitioner in Susquehanna, PA
• Providers in Susquehanna, PA by specialty
• Primary Care Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2015; 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.