Provider Demographics
NPI:1588762033
Name:SPENCER, VARNAR (CRNA)
Entity type:Individual
Prefix:MRS
First Name:VARNAR
Middle Name:
Last Name:SPENCER
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 BRECKENRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:GARNER
Mailing Address - State:NC
Mailing Address - Zip Code:27529-7524
Mailing Address - Country:US
Mailing Address - Phone:919-621-3751
Mailing Address - Fax:
Practice Address - Street 1:132 BRECKENRIDGE DR
Practice Address - Street 2:
Practice Address - City:GARNER
Practice Address - State:NC
Practice Address - Zip Code:27529-7524
Practice Address - Country:US
Practice Address - Phone:919-621-3751
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC173966367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8052655Medicaid
NC193255OtherMEDCOST
NC2611299Medicare PIN