Provider Demographics
NPI:1073964094
Name:SPENCER, KAREN
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:SPENCER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7326 SHAYAN CT
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78414-4256
Mailing Address - Country:US
Mailing Address - Phone:361-826-3333
Mailing Address - Fax:
Practice Address - Street 1:1201 LEOPARD ST FL 6
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78401
Practice Address - Country:US
Practice Address - Phone:361-826-3333
Practice Address - Fax:361-826-3334
Is Sole Proprietor?:No
Enumeration Date:2016-06-30
Last Update Date:2019-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX813577363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily