Provider Demographics
NPI:1386619898
Name:SPENCER, SUSAN BEYER (APRN)
Entity type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:BEYER
Last Name:SPENCER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MS
Other - First Name:SUSAN
Other - Middle Name:BETH
Other - Last Name:BEYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:1521 N COOPER ST
Mailing Address - Street 2:SUITE 630
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76011-5592
Mailing Address - Country:US
Mailing Address - Phone:817-274-8800
Mailing Address - Fax:817-274-8806
Practice Address - Street 1:1521 N. COOPER ST
Practice Address - Street 2:SUITE 630
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76011
Practice Address - Country:US
Practice Address - Phone:817-274-8800
Practice Address - Fax:817-274-8806
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-18
Last Update Date:2013-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX241791363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health