Sparks, Brent Alan

Sparks, Brent Alan is an individual health care provider with primary practice located at 1421 N 7Th St , Terre Haute IN 47807-1005. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Sparks, Brent Alan can be contacted via phone (812) 231-4608.

Contact Information

Primary practice address
1421 N 7Th St Terre Haute IN 47807-1005
Phone: (812) 231-4608
Fax: (812) 231-4675
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 28115785A Indiana

Profile Details

NPI number 1518994813
LBN Legal business name Sparks, Brent Alan
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 26th, 2006
Last updated Jul 23rd, 2015 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1518994813 NPPES
Indiana MEDICAID 200344100 A

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