MEDICARE: RENEE FULTON SPENCER

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number State
1	376J00000X	Homemaker	TN
2	332U00000X	Home Delivered Meals	TN
3	374K00000X	Religious Nonmedical Practitioner	TN
4	174200000X	Meals Provider	TN

General Provider Information

NPI Number	:	1588523310
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RENEE FULTON SPENCER

Provider Business Mailing Address
First Line	:	3007 S PERKINS RD
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38118-3238
Country	:	US
Telephone Number	:	347-317-0122
Fax Number	:

Provider Business Practice Location Address
First Line	:	3007 S PERKINS RD
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38118-3238
Country	:	US
Telephone Number	:	347-317-0122
Fax Number	:

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

Provider Enumeration Date	:	01/19/2026
Last Update Date	:	01/19/2026

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Directions to “ RENEE FULTON SPENCER ” Practice Location

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