Healthcare Provider Details

I. General information

NPI: 1144155656
Provider Name (Legal Business Name): LAUREN BONNEY SPENCER DNP CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2026
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 GRESHAM DR
NORFOLK VA
23507-1904
US

IV. Provider business mailing address

1316 RIVERFRONT CT APT 102
VIRGINIA BEACH VA
23451-5460
US

V. Phone/Fax

Practice location:
  • Phone: 757-567-1619
  • Fax:
Mailing address:
  • Phone: 757-567-1619
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number0024197791
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number0001288564
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: