IVANA SPACIEL APN NPI 1205335957

NPI Information

NPI: 1205335957
Provider Name: IVANA SPACIEL, APN
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Individual

Specialization: Psychiatric/Mental Health

PECOS Registration: Yes

Address:
1220 DEWEY AVE
WAUWATOSA, WI
ZIP 53213
Phone: (414) 773-4312
Get Directions

Ivana Spaciel, APN is a psychiatric/mental health nurse practitioner in Wauwatosa, WI. Ivana Spaciel, APN NPI is 1205335957. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1220 DEWEY AVE
WAUWATOSA, WI
ZIP 53213-504
Phone: (414) 773-4312

The NPI 1205335957 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 2/8/2018 and was last updated on 11/24/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363L00000X	Nurse Practitioner		8836	WISCONSIN	No
2	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	209017238	ILLINOIS	No
3	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	8836	WISCONSIN	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	100084203	MEDICAID	WISCONSIN
2	100084205	MEDICAID	WISCONSIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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