Healthcare Provider Details

I. General information

NPI: 1649015124
Provider Name (Legal Business Name): DONNA L SPENCE FNP-BC PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/27/2024
Last Update Date: 06/27/2024
Certification Date: 06/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5121 MARTIN LUTHER KING JR HWY
GREENVILLE NC
27834-8613
US

IV. Provider business mailing address

4415 PARKER CT
FARMVILLE NC
27828-8528
US

V. Phone/Fax

Practice location:
  • Phone: 252-752-2111
  • Fax: 252-830-8473
Mailing address:
  • Phone: 252-531-3854
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DONNA LYNN SPENCE
Title or Position: MANAGER
Credential: FNP-BC
Phone: 252-531-3854