Provider Demographics
NPI:1821547159
Name:SPATZER, ROBERT (CRNP)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:SPATZER
Suffix:
Gender:M
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:709 DELAWARE AVE
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN HILL
Mailing Address - State:PA
Mailing Address - Zip Code:18015-1107
Mailing Address - Country:US
Mailing Address - Phone:484-526-3890
Mailing Address - Fax:484-526-3046
Practice Address - Street 1:709 DELAWARE AVE
Practice Address - Street 2:
Practice Address - City:FOUNTAIN HILL
Practice Address - State:PA
Practice Address - Zip Code:18015-1107
Practice Address - Country:US
Practice Address - Phone:484-526-3890
Practice Address - Fax:484-526-3046
Is Sole Proprietor?:No
Enumeration Date:2016-09-28
Last Update Date:2016-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN624714363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner