Provider Demographics
NPI:1417688755
Name:SPENCER, LIUDMYLA (LPN)
Entity Type:Individual
Prefix:
First Name:LIUDMYLA
Middle Name:
Last Name:SPENCER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 184
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRINGS
Mailing Address - State:NY
Mailing Address - Zip Code:14550-0184
Mailing Address - Country:US
Mailing Address - Phone:158-544-3068
Mailing Address - Fax:
Practice Address - Street 1:73 ORCHARD ST
Practice Address - Street 2:
Practice Address - City:SILVER SPRINGS
Practice Address - State:NY
Practice Address - Zip Code:14550-9807
Practice Address - Country:US
Practice Address - Phone:585-443-0684
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-17
Last Update Date:2022-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY331038164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse