Provider Demographics
NPI:1215482013
Name:SPENCER, PATRICIA E (NP-C)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:E
Last Name:SPENCER
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 HAWLEY ST
Mailing Address - Street 2:
Mailing Address - City:BINGHAMTON
Mailing Address - State:NY
Mailing Address - Zip Code:13901-3903
Mailing Address - Country:US
Mailing Address - Phone:607-723-5130
Mailing Address - Fax:607-723-4087
Practice Address - Street 1:117 HAWLEY ST
Practice Address - Street 2:
Practice Address - City:BINGHAMTON
Practice Address - State:NY
Practice Address - Zip Code:13901
Practice Address - Country:US
Practice Address - Phone:607-723-5130
Practice Address - Fax:607-723-4087
Is Sole Proprietor?:No
Enumeration Date:2016-08-22
Last Update Date:2019-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY340873363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily