Provider Demographics
NPI:1174702310
Name:SPEAR, GINNY L (LPN)
Entity type:Individual
Prefix:MRS
First Name:GINNY
Middle Name:L
Last Name:SPEAR
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:553 E PLAZA CIR
Mailing Address - Street 2:
Mailing Address - City:LITCHFIELD PARK
Mailing Address - State:AZ
Mailing Address - Zip Code:85340-4930
Mailing Address - Country:US
Mailing Address - Phone:623-547-1218
Mailing Address - Fax:623-547-4770
Practice Address - Street 1:13335 W MISSOURI AVE
Practice Address - Street 2:
Practice Address - City:LITCHFIELD PARK
Practice Address - State:AZ
Practice Address - Zip Code:85340-8500
Practice Address - Country:US
Practice Address - Phone:623-547-1218
Practice Address - Fax:623-547-4770
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-24
Last Update Date:2007-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLP037917164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse