Provider Demographics
NPI:1992057517
Name:SPENCER, CLAUDIA TRACEY-ANN (RN)
Entity type:Individual
Prefix:MISS
First Name:CLAUDIA
Middle Name:TRACEY-ANN
Last Name:SPENCER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14031 183RD ST
Mailing Address - Street 2:PH
Mailing Address - City:SPRINGFIELD GARDENS
Mailing Address - State:NY
Mailing Address - Zip Code:11413-3040
Mailing Address - Country:US
Mailing Address - Phone:646-644-4750
Mailing Address - Fax:
Practice Address - Street 1:14031 183RD ST
Practice Address - Street 2:PH
Practice Address - City:SPRINGFIELD GARDENS
Practice Address - State:NY
Practice Address - Zip Code:11413-3040
Practice Address - Country:US
Practice Address - Phone:646-644-4750
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-05
Last Update Date:2012-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY655680-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse