Provider Demographics
NPI:1417712837
Name:SPENCER, ANDREA RITA (APRN FNP-C)
Entity Type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:RITA
Last Name:SPENCER
Suffix:
Gender:F
Credentials:APRN FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13740 OFFICE PARK CT STE C
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:FL
Mailing Address - Zip Code:34667-7145
Mailing Address - Country:US
Mailing Address - Phone:727-869-5100
Mailing Address - Fax:727-869-5166
Practice Address - Street 1:13740 OFFICE PARK CT STE C
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:FL
Practice Address - Zip Code:34667-7145
Practice Address - Country:US
Practice Address - Phone:727-869-5100
Practice Address - Fax:727-869-5166
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-15
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11031281363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily