MEDICARE: NANCY SPENCER LM

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	176B00000X	Midwife	MW00000039	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1770662728
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NANCY SPENCER LM

Provider Business Mailing Address
First Line	:	2722 214 AVE EAST
Second Line	:
City	:	LAKE TAPPS
State	:	WA
Zip	:	98391-6245
Country	:	US
Telephone Number	:	253-862-6533
Fax Number	:	253-862-1840

Provider Business Practice Location Address
First Line	:	2722 214 AVE EAST
Second Line	:
City	:	LAKE TAPPS
State	:	WA
Zip	:	98391-6245
Country	:	US
Telephone Number	:	253-862-6533
Fax Number	:	253-862-1840

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

Provider Enumeration Date	:	11/02/2006
Last Update Date	:	07/08/2007

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Directions to “ NANCY SPENCER LM” Practice Location

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