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NPI Code Detail

MEDICARE: MICHAEL SPENCER VINSON DNP, FNP-BC

MEDICARE: MICHAEL SPENCER VINSON DNP, FNP-BC
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
1363LF0000XFamily Nurse Practitioner224090AR
2363L00000XNurse Practitioner2024000248MO

General Provider Information

NPI Number : 1235821166
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL SPENCER VINSON DNP, FNP-BC
Provider Business Mailing Address
First Line : PO BOX 776084
Second Line :
City : CHICAGO
State : IL
Zip : 60677-6084
Country : US
Telephone Number : 479-273-7700
Fax Number : 479-464-7734
Provider Business Practice Location Address
First Line : 1001 S HORSEBARN RD
Second Line :
City : ROGERS
State : AR
Zip : 72758-8184
Country : US
Telephone Number : 479-273-7700
Fax Number : 479-464-7734
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/22/2023
Last Update Date : 03/10/2026

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