Healthcare Provider Details

I. General information

NPI: 1609980564
Provider Name (Legal Business Name): DORAINE GRIESER SPENCER FNP-C, MSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2006
Last Update Date: 03/01/2023
Certification Date: 03/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

631 MOCKSVILLE AVE STE 1020
SALISBURY NC
28144-2731
US

IV. Provider business mailing address

PO BOX 604061
CHARLOTTE NC
28260-4061
US

V. Phone/Fax

Practice location:
  • Phone: 704-210-7600
  • Fax: 704-210-7601
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number0050-00975
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: