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General NPI Number Information
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NPI Number | 1669140281
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Entity Type | Individual
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Provider Name | NANETTE LOCOLE SPENCER FNP
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Gender | Female
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Dates
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Enumeration Date | 08/30/2021
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Last Update Date | 03/05/2025
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Provider Practice Location Address
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Address Line | 6613 HICKORY FLAT HWY
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City | CANTON
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State | GA
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Zip | 30115-7237
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Country | US
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Telephone | 770-268-4357
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Fax | 470-251-6064
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Provider Business Mailing Address
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Address Line | 3333 RIVERWOOD PKWY SE STE 250
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City | ATLANTA
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State | GA
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Zip | 30339-3304
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Country | US
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Telephone | 770-914-0016
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Fax | 770-955-4278
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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 | RN250345
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License Number State | GA
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