Provider Demographics
NPI:1871875476
Name:SPINKS, PAULA ANN (PA-C)
Entity type:Individual
Prefix:
First Name:PAULA
Middle Name:ANN
Last Name:SPINKS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3360 BONNIEBROOK CT
Mailing Address - Street 2:
Mailing Address - City:OAKLAND TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48306-1466
Mailing Address - Country:US
Mailing Address - Phone:248-276-1186
Mailing Address - Fax:248-844-9784
Practice Address - Street 1:1701 SOUTH BLVD E
Practice Address - Street 2:SUITE 300
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48307-6122
Practice Address - Country:US
Practice Address - Phone:248-844-9710
Practice Address - Fax:248-844-9784
Is Sole Proprietor?:No
Enumeration Date:2011-09-09
Last Update Date:2011-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5601002638363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical