Provider Demographics
NPI:1487953204
Name:SPANGLER, CARRIE FELLOWS
Entity type:Individual
Prefix:MS
First Name:CARRIE
Middle Name:FELLOWS
Last Name:SPANGLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 TREMONT ST
Mailing Address - Street 2:11P
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02111-1125
Mailing Address - Country:US
Mailing Address - Phone:504-402-0130
Mailing Address - Fax:
Practice Address - Street 1:151 TREMONT ST
Practice Address - Street 2:11P
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02111-1125
Practice Address - Country:US
Practice Address - Phone:504-402-0130
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-18
Last Update Date:2011-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program