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General NPI Number Information
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NPI Number | 1003346412
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Entity Type | Individual
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Provider Name | GWENDOLYN WILLIAMS SPANGLER NP-C
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Gender | Female
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Dates
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Enumeration Date | 06/18/2017
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Last Update Date | 02/07/2025
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Provider Practice Location Address
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Address Line | 402 CAMPBELL AVE SW
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City | ROANOKE
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State | VA
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Zip | 24016-3627
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Country | US
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Telephone | 540-400-7431
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Fax |
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Provider Business Mailing Address
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Address Line | 206 RADFORD RD SE
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City | FLOYD
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State | VA
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Zip | 24091-4737
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Country | US
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Telephone | 540-353-2439
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 0024174952
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 0024174952
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License Number State | VA
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