Healthcare Provider Details

I. General information

NPI: 1649993684
Provider Name (Legal Business Name): SPENCER FRANCES MARTIN CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SPENCER FRANCES MARTIN CRNP

II. Dates (important events)

Enumeration Date: 09/23/2022
Last Update Date: 11/08/2022
Certification Date: 11/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 MEDICAL PKWY
ANNAPOLIS MD
21401-3773
US

IV. Provider business mailing address

105 MARION QUIMBY DR
STEVENSVILLE MD
21666-2529
US

V. Phone/Fax

Practice location:
  • Phone: 410-507-8279
  • Fax:
Mailing address:
  • Phone: 443-838-7200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberR220752
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberR220752
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberR220752
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: