Provider Demographics
NPI:1457173346
Name:SPENCER, HANNAH (LPN)
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:
Last Name:SPENCER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:381 POCAHONTAS AVE
Mailing Address - Street 2:
Mailing Address - City:SPRING CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37381-4104
Mailing Address - Country:US
Mailing Address - Phone:931-214-9197
Mailing Address - Fax:
Practice Address - Street 1:381 POCAHONTAS AVE
Practice Address - Street 2:
Practice Address - City:SPRING CITY
Practice Address - State:TN
Practice Address - Zip Code:37381-4104
Practice Address - Country:US
Practice Address - Phone:931-214-9197
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-30
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN101596164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse