Provider Demographics
NPI:1578077160
Name:SPENCER, MARCIA (ARNP)
Entity Type:Individual
Prefix:MISS
First Name:MARCIA
Middle Name:
Last Name:SPENCER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:MRS
Other - First Name:MARCIA
Other - Middle Name:
Other - Last Name:BRYANT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2761 HORSESHOE CT
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34235-1835
Mailing Address - Country:US
Mailing Address - Phone:860-888-4497
Mailing Address - Fax:
Practice Address - Street 1:2761 HORSESHOE CT
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34235-1835
Practice Address - Country:US
Practice Address - Phone:941-756-1200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-20
Last Update Date:2017-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9458781363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health