Provider Demographics
NPI:1760678726
Name:SPOONER, NANCY COLLEEN (ANP)
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:COLLEEN
Last Name:SPOONER
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:MISS
Other - First Name:NANCY
Other - Middle Name:COLLEEN
Other - Last Name:MCGURN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4001 LAKE OTIS PARKWAY
Mailing Address - Street 2:#101
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508
Mailing Address - Country:US
Mailing Address - Phone:907-563-2229
Mailing Address - Fax:907-563-7419
Practice Address - Street 1:4001 LAKE OTIS PARKWAY
Practice Address - Street 2:#101
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508
Practice Address - Country:US
Practice Address - Phone:907-563-2229
Practice Address - Fax:907-563-7419
Is Sole Proprietor?:No
Enumeration Date:2007-09-23
Last Update Date:2011-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMR63683363LW0102X
AK647363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health