Provider Demographics
NPI:1669172458
Name:SPENCER, BRITANY NICOLE (PRSS)
Entity type:Individual
Prefix:
First Name:BRITANY
Middle Name:NICOLE
Last Name:SPENCER
Suffix:
Gender:F
Credentials:PRSS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:306 DOUGLAS ST
Mailing Address - Street 2:
Mailing Address - City:DUNBAR
Mailing Address - State:WV
Mailing Address - Zip Code:25064-3462
Mailing Address - Country:US
Mailing Address - Phone:681-265-5082
Mailing Address - Fax:
Practice Address - Street 1:209 2ND ST N
Practice Address - Street 2:
Practice Address - City:SAINT ALBANS
Practice Address - State:WV
Practice Address - Zip Code:25177-1530
Practice Address - Country:US
Practice Address - Phone:681-265-5082
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-09
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV23-945175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist