Provider Demographics
NPI:1942980040
Name:MESSINA, SPENCER REEVE
Entity Type:Individual
Prefix:
First Name:SPENCER
Middle Name:REEVE
Last Name:MESSINA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2763 SACRED CT
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-4502
Mailing Address - Country:US
Mailing Address - Phone:702-752-6894
Mailing Address - Fax:
Practice Address - Street 1:2763 SACRED CT
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-4502
Practice Address - Country:US
Practice Address - Phone:702-752-6894
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-24
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program