Provider Demographics
NPI:1134156599
Name:SPENCER, LINDA C (RN, NP)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:C
Last Name:SPENCER
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Gender:F
Credentials:RN, NP
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Other - Last Name:
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Mailing Address - Street 1:3800 WOODWARD AVE
Mailing Address - Street 2:SUITE 702
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48201-2061
Mailing Address - Country:US
Mailing Address - Phone:313-262-1303
Mailing Address - Fax:313-262-1238
Practice Address - Street 1:CHILDRENS HOSPITAL MI NEPHROLOGY
Practice Address - Street 2:3901 BEAUBIEN 2ND FLOOR - CARL'S BUILDING
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48201
Practice Address - Country:US
Practice Address - Phone:313-745-5604
Practice Address - Fax:313-966-0039
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4704160416363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner