Theresa A Sparks


Address: 2111 Egret Ln, Fernandina Beach, FL 32034-4445

Theresa A Sparks (NPI# 1538138367, PAC ID# 5193035038) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PSYCHOLOGIST, CLINICAL.

Physician Overview

Nation Provider ID (NPI) 1538138367
PAC ID by PECOS 5193035038
Professional Enrollment ID I20151105001749
Full Name Theresa A Sparks
Address 2111 Egret Ln
Fernandina Beach
FL 32034-4445
Gender F
Graduation Year 2003
Primary Specialty PSYCHOLOGIST, CLINICAL
Accepts Medicare Assignment Y

Other Locations

Address Phone Organization
2111 Egret Ln, Fernandina Beach, FL 32034-4445

Organization Information

Office Location

Street Address 2111 EGRET LN
City FERNANDINA BEACH
State FL
Zip 32034-4445

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Competitor

Search similar physicians

City FERNANDINA BEACH
Zip Code 32034
Specialty PSYCHOLOGIST, CLINICAL
City + Specialty FERNANDINA BEACH + PSYCHOLOGIST, CLINICAL

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS)
Jurisdiction Medicare

This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.

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