Provider Demographics
NPI:1992474795
Name:SPENCER, STEPHANIE CLAIRE (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:CLAIRE
Last Name:SPENCER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:319 MINERAL AVE
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59718-6247
Mailing Address - Country:US
Mailing Address - Phone:832-785-7513
Mailing Address - Fax:
Practice Address - Street 1:319 MINERAL AVE
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59718-6247
Practice Address - Country:US
Practice Address - Phone:832-785-7513
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-07
Last Update Date:2021-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTNUR-RN-LIC-178225163WE0003X
MT178226363LF0000X
MTNUR-APRN-LIC-178226363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WE0003XNursing Service ProvidersRegistered NurseEmergency