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General NPI Number Information
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NPI Number | 1477315240
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Entity Type | Individual
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Provider Name | KAREN WATTS SPENCER FNP-C
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Gender | Female
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Dates
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Enumeration Date | 01/26/2024
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Last Update Date | 10/15/2025
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Provider Practice Location Address
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Address Line | 190 KIMEL PARK DR STE 140
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City | WINSTON SALEM
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State | NC
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Zip | 27103-6946
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Country | US
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Telephone | 336-277-2225
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Fax |
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Provider Business Mailing Address
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Address Line | 165 HARPER RIDGE CT
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City | CLEMMONS
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State | NC
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Zip | 27012-7429
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Country | US
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Telephone | 133-640-7213
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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 | 163WM0705X
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Taxonomy Name | Medical-Surgical Registered Nurse
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License Number | 151688
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 5022470
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License Number State | NC
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