Provider Demographics
NPI:1609045178
Name:SPENCER, VALERIE (CFNP)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:
Last Name:SPENCER
Suffix:
Gender:F
Credentials:CFNP
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 628
Mailing Address - Street 2:
Mailing Address - City:TUCUMCARI
Mailing Address - State:NM
Mailing Address - Zip Code:88401-0628
Mailing Address - Country:US
Mailing Address - Phone:575-461-2222
Mailing Address - Fax:575-461-2255
Practice Address - Street 1:325 S 1ST ST
Practice Address - Street 2:
Practice Address - City:TUCUMCARI
Practice Address - State:NM
Practice Address - Zip Code:88401-2707
Practice Address - Country:US
Practice Address - Phone:575-461-2222
Practice Address - Fax:575-461-2255
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-28
Last Update Date:2008-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMR63323363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily