Provider Demographics
NPI:1558757351
Name:SPENCER, MARY LEIGH (RN, FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:LEIGH
Last Name:SPENCER
Suffix:
Gender:F
Credentials:RN, FNP-BC
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:LEIGH
Other - Last Name:YOUSSI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:6330 SAINT HENRY DR
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37205-4121
Mailing Address - Country:US
Mailing Address - Phone:615-424-9776
Mailing Address - Fax:
Practice Address - Street 1:4928 EDMONDSON PIKE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37211-4787
Practice Address - Country:US
Practice Address - Phone:615-222-1400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-08
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN19840363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily