Provider Demographics
NPI:1386332286
Name:SPENCER, ROBBIE (FNP)
Entity type:Individual
Prefix:
First Name:ROBBIE
Middle Name:
Last Name:SPENCER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 AVALON CT
Mailing Address - Street 2:
Mailing Address - City:WOODVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75979-6403
Mailing Address - Country:US
Mailing Address - Phone:409-363-9131
Mailing Address - Fax:
Practice Address - Street 1:103 AVALON CT
Practice Address - Street 2:
Practice Address - City:WOODVILLE
Practice Address - State:TX
Practice Address - Zip Code:75979-6403
Practice Address - Country:US
Practice Address - Phone:409-363-9131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-27
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP138006363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner