NPI Code Detail JSON Logo

1285940965 NPI number — JERI K. SPENCER NP

NPI Number: 1285940965
Health Care Provider/Practitioner: JERI K. SPENCER NP

Information about “1285940965” NPI (JERI K. SPENCER NP) exists in 1285940965 in HTML format HTML  |  1285940965 in plain Text format TXT  |  1285940965 in PDF (Portable Document Format) PDF  |  1285940965 in an XML format XML  formats.

NPI Number : 1285940965 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1285940965",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "SPENCER",
    "FirstName": "JERI",
    "MiddleName": "K.",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "NP",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "190 E BANNOCK ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "BOISE",
    "MailingAddressStateName": "ID",
    "MailingAddressPostalCode": "83712",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "208-381-2222",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "100 E WARM SPRINGS AVE",
    "SecondLinePracticeLocationAddress": "SUITE B",
    "PracticeLocationAddressCityName": "BOISE",
    "PracticeLocationAddressStateName": "ID",
    "PracticeLocationAddressPostalCode": "83712-6243",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "208-381-6930",
    "PracticeLocationAddressFaxNumber": "208-381-6931",
    "EnumerationDate": "08/19/2010",
    "LastUpdateDate": "10/15/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "363L00000X",
          "TaxonomyName": "Nurse Practitioner",
          "LicenseNumber": "GAA-NP003088",
          "LicenseNumberStateCode": "GA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363LF0000X",
          "TaxonomyName": "Family Nurse Practitioner",
          "LicenseNumber": "NP967A",
          "LicenseNumberStateCode": "ID",
          "PrimaryTaxonomySwitch": "Y"
        },
        {
          "TaxonomyCode": "363L00000X",
          "TaxonomyName": "Nurse Practitioner",
          "LicenseNumber": "95416455",
          "LicenseNumberStateCode": "CA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363L00000X",
          "TaxonomyName": "Nurse Practitioner",
          "LicenseNumber": "AP3610",
          "LicenseNumberStateCode": "AZ",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363L00000X",
          "TaxonomyName": "Nurse Practitioner",
          "LicenseNumber": "1194699",
          "LicenseNumberStateCode": "TX",
          "PrimaryTaxonomySwitch": "N"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.