Mattea Rose Span

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

4704340419 Issued in MI

Practice address

715 Pyle Dr
Kingsford, MI 49802-4456

Phone

(906) 774-0522

Fax

(906) 774-1570

NPI assigned

May 31, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

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": "1653955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664150400000",
    "number": "1891434882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 BALSAM ST",
            "city": "KINGSFORD",
            "state": "MI",
            "postal_code": "498025203",
            "telephone_number": "906-282-3134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 PYLE DR",
            "city": "KINGSFORD",
            "state": "MI",
            "postal_code": "498024456",
            "telephone_number": "906-774-0522",
            "fax_number": "906-774-1570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPAN",
        "first_name": "MATTEA",
        "middle_name": "ROSE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-31",
        "last_updated": "2022-09-26",
        "certification_date": "2022-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0600X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Gerontology",
            "state": "WI",
            "license": "243214",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704340419",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Sliva, BT
• Sherry A Smith-Labrash, LSST
• Ashtyn Elizabeth Smith
• Patrick William Smith, LLMSW
• Michael Smithson
• Kylie Stapleton
• Laura Leeann Steber, D.C.
• Trista Steinbeck
• Maia Steinbrecher
• Mollie Luella Steinbrecher

• Registered Nurse in Kingsford, MI
• Providers in Kingsford, MI by specialty
• Registered Nurse in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2022; 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.