Basic Information
Provider Information
NPI: 1306273628
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: OH-SPRADLING
FirstName: LEIA
MiddleName: FINE
NamePrefix:  
NameSuffix:  
Credential: RN, ACNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 406 S COTTONWOOD DR
Address2:  
City: RICHARDSON
State: TX
PostalCode: 750805708
CountryCode: US
TelephoneNumber: 8178212507
FaxNumber:  
Practice Location
Address1: 221 W COLORADO BLVD
Address2: #929
City: DALLAS
State: TX
PostalCode: 752082363
CountryCode: US
TelephoneNumber: 2149605681
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/01/2013
LastUpdateDate: 09/19/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LC0200XAP124519TXY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCritical Care Medicine

No ID Information.


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