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General NPI Number Information
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NPI Number | 1972698181
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Entity Type | Individual
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Provider Name | AMY NICOLE SPENCER RN
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Gender | Female
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Dates
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Enumeration Date | 10/04/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3838 N. RURAL
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City | INDIANAPOLIS
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State | IN
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Zip | 46205-2930
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Country | US
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Telephone | 317-221-2306
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Fax | 317-221-2336
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Provider Business Mailing Address
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Address Line | 8947 BAKERS CORNER DRIVE
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City | CAMBY
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State | IN
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Zip | 46113
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Country | US
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Telephone |
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 28154070A
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License Number State | IN
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