Provider Demographics
NPI:1033996764
Name:SPENCER, ALYSON CLAIRE (RN)
Entity Type:Individual
Prefix:MS
First Name:ALYSON
Middle Name:CLAIRE
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 1:409 WHITNEY AVE APT 10
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06511-2341
Mailing Address - Country:US
Mailing Address - Phone:978-857-8437
Mailing Address - Fax:
Practice Address - Street 1:409 WHITNEY AVE APT 10
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-2341
Practice Address - Country:US
Practice Address - Phone:978-857-8437
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-14
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2358817163W00000X
CT192565163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse