Provider Demographics
NPI:1316605009
Name:SPIELBAUER, MARY (APNP)
Entity type:Individual
Prefix:DR
First Name:MARY
Middle Name:
Last Name:SPIELBAUER
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:
Other - Last Name:BARES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:4469 HILLCREST DR
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53705-5020
Mailing Address - Country:US
Mailing Address - Phone:608-692-0938
Mailing Address - Fax:
Practice Address - Street 1:4469 HILLCREST DR
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53705-5020
Practice Address - Country:US
Practice Address - Phone:608-692-0938
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-30
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI11304363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care