Provider Demographics
NPI:1659932994
Name:SPENCER-COLE, JUDITH CHINWE (FNP)
Entity Type:Individual
Prefix:MRS
First Name:JUDITH
Middle Name:CHINWE
Last Name:SPENCER-COLE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:N/A
Other - Middle Name:N/A
Other - Last Name:N/A
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NURSE PRACTITIONER
Mailing Address - Street 1:2 WATERS EDGE DR
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72204-8645
Mailing Address - Country:US
Mailing Address - Phone:501-247-9663
Mailing Address - Fax:
Practice Address - Street 1:2 WATERS EDGE DR
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72204-8645
Practice Address - Country:US
Practice Address - Phone:501-247-9663
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-27
Last Update Date:2019-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA006155363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily