Provider Demographics
NPI:1164609475
Name:SPENCE, IRENE V (RN, NP)
Entity Type:Individual
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First Name:IRENE
Middle Name:V
Last Name:SPENCE
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Gender:F
Credentials:RN, NP
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Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:4230 HARDING PIKE
Mailing Address - Street 2:SUITE 435
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37205-2013
Mailing Address - Country:US
Mailing Address - Phone:615-385-3704
Mailing Address - Fax:615-292-1321
Practice Address - Street 1:4230 HARDING PIKE
Practice Address - Street 2:SUITE 435
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37205-2013
Practice Address - Country:US
Practice Address - Phone:615-385-3704
Practice Address - Fax:615-292-1321
Is Sole Proprietor?:No
Enumeration Date:2008-01-29
Last Update Date:2015-02-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TNAPN12118363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1507725Medicaid
TN1507725Medicaid