Spiller, Mary Joann

Spiller, Mary Joann is an sole proprietor health care provider with primary practice located at 1405 Mill St , New London WI 54961-2155. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Spiller, Mary Joann can be contacted via phone (920) 531-2400.

Contact Information

Primary practice address
1405 Mill St New London WI 54961-2155
Phone: (920) 531-2400
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 209004508 Illinois
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 2144 Wisconsin
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 2144 Wisconsin

Profile Details

NPI number 1639153877
LBN Legal business name Spiller, Mary Joann
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 1st, 2005
Last updated Apr 25th, 2023 - about 3 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 1639153877 NPPES
Wisconsin MEDICAID 43988800
Wisconsin Other F400254738
Wisconsin Other 206147

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