Provider Demographics
NPI:1982815494
Name:SPENCER, RANDA JANELL (FNP-C)
Entity Type:Individual
Prefix:
First Name:RANDA
Middle Name:JANELL
Last Name:SPENCER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:RANDA
Other - Middle Name:
Other - Last Name:CASADOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2695 ROCKY MOUNTAIN AVE STE 150
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-9071
Mailing Address - Country:US
Mailing Address - Phone:970-624-4123
Mailing Address - Fax:970-624-2416
Practice Address - Street 1:13631 COLORADO BLVD
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80602-7051
Practice Address - Country:US
Practice Address - Phone:303-252-2960
Practice Address - Fax:303-252-2964
Is Sole Proprietor?:No
Enumeration Date:2007-05-25
Last Update Date:2023-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0004332-NP363LF0000X
CO4332363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner