Provider Demographics
NPI:1962014894
Name:WOOLEN, SPENCER (AGPC-NP)
Entity Type:Individual
Prefix:
First Name:SPENCER
Middle Name:
Last Name:WOOLEN
Suffix:
Gender:F
Credentials:AGPC-NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3333 S WADSWORTH BLVD UNIT D100
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80227-5117
Mailing Address - Country:US
Mailing Address - Phone:720-544-2064
Mailing Address - Fax:303-347-3080
Practice Address - Street 1:13111 E BRIARWOOD AVE STE 300
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-3913
Practice Address - Country:US
Practice Address - Phone:303-671-0553
Practice Address - Fax:303-671-0332
Is Sole Proprietor?:No
Enumeration Date:2020-08-21
Last Update Date:2020-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0995800-NP363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology