Provider Demographics
NPI:1649749250
Name:SPENCER, LINDSAY (FNP)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:
Last Name:SPENCER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1060 LEWIS FERRELL RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH BOSTON
Mailing Address - State:VA
Mailing Address - Zip Code:24592-6768
Mailing Address - Country:US
Mailing Address - Phone:910-381-2923
Mailing Address - Fax:
Practice Address - Street 1:3601 OLD HALIFAX RD STE 100
Practice Address - Street 2:
Practice Address - City:SOUTH BOSTON
Practice Address - State:VA
Practice Address - Zip Code:24592-4953
Practice Address - Country:US
Practice Address - Phone:434-290-1225
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-13
Last Update Date:2018-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024176425363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily