Provider Demographics
NPI:1295757391
Name:SPEARS, SHIRLEY (MS, ANP, BC)
Entity type:Individual
Prefix:
First Name:SHIRLEY
Middle Name:
Last Name:SPEARS
Suffix:
Gender:F
Credentials:MS, ANP, BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 793
Mailing Address - Street 2:
Mailing Address - City:OOLTEWAH
Mailing Address - State:TN
Mailing Address - Zip Code:37363-0793
Mailing Address - Country:US
Mailing Address - Phone:423-238-0033
Mailing Address - Fax:
Practice Address - Street 1:5121 OOLTEWAH-RINGGOLD ROAD
Practice Address - Street 2:SUITE D
Practice Address - City:COLLEGEDALE
Practice Address - State:TN
Practice Address - Zip Code:37315
Practice Address - Country:US
Practice Address - Phone:423-238-0033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN5112363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health