Provider Demographics
NPI:1871101592
Name:SPAHR, MELISHA RENEE (RN)
Entity type:Individual
Prefix:
First Name:MELISHA
Middle Name:RENEE
Last Name:SPAHR
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3 BURNS CROSSING RD
Mailing Address - Street 2:
Mailing Address - City:SEVERN
Mailing Address - State:MD
Mailing Address - Zip Code:21144-3218
Mailing Address - Country:US
Mailing Address - Phone:443-756-7164
Mailing Address - Fax:
Practice Address - Street 1:9000 FRANKLIN SQUARE DRIVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21237
Practice Address - Country:US
Practice Address - Phone:443-725-8245
Practice Address - Fax:443-725-8217
Is Sole Proprietor?:No
Enumeration Date:2020-07-20
Last Update Date:2020-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR177708363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner