Provider Demographics
NPI:1255444618
Name:SPENCE, CLAIRE T (NP)
Entity type:Individual
Prefix:
First Name:CLAIRE
Middle Name:T
Last Name:SPENCE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:THAIS
Other - Middle Name:H
Other - Last Name:SPENCE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:155 AVENUE E
Mailing Address - Street 2:
Mailing Address - City:APALACHICOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32320-2069
Mailing Address - Country:US
Mailing Address - Phone:850-653-8600
Mailing Address - Fax:850-653-8604
Practice Address - Street 1:155 AVENUE E
Practice Address - Street 2:
Practice Address - City:APALACHICOLA
Practice Address - State:FL
Practice Address - Zip Code:32320-2069
Practice Address - Country:US
Practice Address - Phone:850-653-8600
Practice Address - Fax:850-653-8604
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2018-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71000400363L00000X
FLARNP9275934363L00000X
KY3006360363LF0000X
FLARNP9460287363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
INP00035874OtherRAILROAD MEDICARE
KY7100101530Medicaid
INP01027960OtherRR MEDICARE PTAN
IN200175580Medicaid
IN204870BMedicare PIN
INP01027960OtherRR MEDICARE PTAN
INP00035874OtherRAILROAD MEDICARE