Provider Demographics
NPI:1114616661
Name:HULL-RAFFERTY, SPENSER TERESA (PA)
Entity Type:Individual
Prefix:
First Name:SPENSER
Middle Name:TERESA
Last Name:HULL-RAFFERTY
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 RANKIN ST APT 2
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01605-1803
Mailing Address - Country:US
Mailing Address - Phone:508-713-7775
Mailing Address - Fax:
Practice Address - Street 1:10 LINCOLN ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01605-2642
Practice Address - Country:US
Practice Address - Phone:508-373-5607
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-02
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant