Provider Demographics
NPI:1124853668
Name:SPRAGGINS, TORI BREANNE (PA-C)
Entity type:Individual
Prefix:
First Name:TORI
Middle Name:BREANNE
Last Name:SPRAGGINS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:805 W MORRIS AVE
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:LA
Mailing Address - Zip Code:70403-4029
Mailing Address - Country:US
Mailing Address - Phone:318-990-2045
Mailing Address - Fax:
Practice Address - Street 1:12525 PERKINS RD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70810-1907
Practice Address - Country:US
Practice Address - Phone:225-819-8857
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-04
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant