Provider Demographics
NPI:1932487071
Name:SPENCE, ERICA A (RN)
Entity Type:Individual
Prefix:MISS
First Name:ERICA
Middle Name:A
Last Name:SPENCE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5927 COVERDALE WAY APT C
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22310-5413
Mailing Address - Country:US
Mailing Address - Phone:703-924-1755
Mailing Address - Fax:
Practice Address - Street 1:5927 COVERDALE WAY APT C
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22310-5413
Practice Address - Country:US
Practice Address - Phone:703-924-1755
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-22
Last Update Date:2011-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001186853163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse