MEDICARE: NATALIA C SPENCER NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2200X	Adult Health Nurse Practitioner	0993309-NP	CO

General Provider Information

NPI Number	:	1235648890
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NATALIA C SPENCER NP

Provider Business Mailing Address
First Line	:	10900 W 44TH AVE UNIT 200
Second Line	:
City	:	WHEAT RIDGE
State	:	CO
Zip	:	80033-2742
Country	:	US
Telephone Number	:	720-548-1194
Fax Number	:	303-423-7004

Provider Business Practice Location Address
First Line	:	1526 COLE BLVD STE 300
Second Line	:
City	:	LAKEWOOD
State	:	CO
Zip	:	80401-3410
Country	:	US
Telephone Number	:	303-379-9371
Fax Number	:	303-284-4082

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/27/2017
Last Update Date	:	04/19/2018

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