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General NPI Number Information
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NPI Number | 1023444551
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Entity Type | Individual
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Provider Name | KRISTAL LARE SPENCER FNP
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Gender | Female
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Dates
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Enumeration Date | 09/16/2013
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Last Update Date | 12/08/2025
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Provider Practice Location Address
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Address Line | 719 W COKE RD STE 6
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City | WINNSBORO
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State | TX
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Zip | 75494-3060
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Country | US
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Telephone | 903-342-3760
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 846098
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City | DALLAS
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State | TX
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Zip | 75284-6098
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Country | US
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Telephone | 903-324-6400
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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 | 702355
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License Number State | TX
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