Provider Demographics
NPI:1447919568
Name:SPANN, KAREN YVETTE (MED)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:YVETTE
Last Name:SPANN
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1713 UNICORN DR
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23454-6871
Mailing Address - Country:US
Mailing Address - Phone:757-404-3326
Mailing Address - Fax:
Practice Address - Street 1:6330 N CENTER DR STE 200
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23502-4008
Practice Address - Country:US
Practice Address - Phone:757-233-0003
Practice Address - Fax:757-233-1669
Is Sole Proprietor?:No
Enumeration Date:2021-12-16
Last Update Date:2021-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374700000XNursing Service Related ProvidersTechnician