Provider Demographics
NPI:1942904461
Name:SPENCER, MORGAN DELANEY
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:DELANEY
Last Name:SPENCER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2309 ADAMS AVE APT 30
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25704-1361
Mailing Address - Country:US
Mailing Address - Phone:937-631-7581
Mailing Address - Fax:
Practice Address - Street 1:1 UNIVERSITY OF NEW MEXICO MSC10 5620
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87131-0001
Practice Address - Country:US
Practice Address - Phone:505-272-3160
Practice Address - Fax:505-272-9427
Is Sole Proprietor?:No
Enumeration Date:2023-03-28
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program