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NPI Code Detail

MEDICARE: KIMBERLY A SPENCER CNP

MEDICARE: KIMBERLY A SPENCER CNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerNP07474OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1588684740
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIMBERLY A SPENCER CNP
Provider Business Mailing Address
First Line : PO BOX 188
Second Line : 1049 WESTERN AVENUE
City : CHILLICOTHEE
State : OH
Zip : 45601-0188
Country : US
Telephone Number : 740-773-4366
Fax Number : 740-773-7855
Provider Business Practice Location Address
First Line : 25716 WILSON ST
Second Line :
City : COOLVILLE
State : OH
Zip : 45723-8153
Country : US
Telephone Number : 740-846-0008
Fax Number : 740-846-0098
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/20/2006
Last Update Date : 08/06/2013

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Directions to “ KIMBERLY A SPENCER CNP” Practice Location

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