Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | 4431 | MN |
Y | 363L00000X | Nurse Practitioner | 6872 | WI |
N | 363LA2100X | Nurse Practitioner - Acute Care | CNP 4431 | MN |
N | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 95003352 | CA |
NPI | 1073974812 |
---|---|
Provider Name | Maria Joan Spadaro |
First Address | Eau Claire, WI 54702-1510 |
Second Address | Eau Claire, WI 54703 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/03/2016 |
Last Update Date | 06/10/2020 |