Provider Demographics
NPI:1275627952
Name:SPENCER, KAREN L (ACNP-BC CRNP)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:L
Last Name:SPENCER
Suffix:
Gender:F
Credentials:ACNP-BC CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12818 CAROUSEL CT
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20772-6402
Mailing Address - Country:US
Mailing Address - Phone:313-478-6338
Mailing Address - Fax:
Practice Address - Street 1:50 IRVING STREET N.W.
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20422
Practice Address - Country:US
Practice Address - Phone:202-745-5616
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2008-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR162713363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care