Provider Demographics
NPI:1972701720
Name:SPENCER, ROBERT E (RN FNP)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:E
Last Name:SPENCER
Suffix:
Gender:M
Credentials:RN FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 HILLWOOD DR
Mailing Address - Street 2:
Mailing Address - City:DICKSON
Mailing Address - State:TN
Mailing Address - Zip Code:37055-1525
Mailing Address - Country:US
Mailing Address - Phone:615-740-5522
Mailing Address - Fax:615-446-9168
Practice Address - Street 1:404 E COLLEGE ST
Practice Address - Street 2:
Practice Address - City:DICKSON
Practice Address - State:TN
Practice Address - Zip Code:37055-1855
Practice Address - Country:US
Practice Address - Phone:615-740-5522
Practice Address - Fax:615-446-3437
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN0000044631363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily