Provider Demographics
NPI:1699883827
Name:SPRING, MARLA JB (FNP-C MSN CDE)
Entity type:Individual
Prefix:
First Name:MARLA
Middle Name:JB
Last Name:SPRING
Suffix:
Gender:F
Credentials:FNP-C MSN CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 12622
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-4017
Mailing Address - Country:US
Mailing Address - Phone:443-481-5134
Mailing Address - Fax:443-481-6515
Practice Address - Street 1:2000 MEDICAL PKWY STE 510
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-3747
Practice Address - Country:US
Practice Address - Phone:443-481-4600
Practice Address - Fax:443-481-3990
Is Sole Proprietor?:No
Enumeration Date:2006-08-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024154175363LF0000X
TX0001154175363LF0000X
MDR214477363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD339403400Medicaid
404480Y5ZOtherMEDICARE PTAN
MD339403400Medicaid