Provider Demographics
NPI:1750496428
Name:SPENCE, GAYL JULIE (FNP-BC)
Entity type:Individual
Prefix:
First Name:GAYL
Middle Name:JULIE
Last Name:SPENCE
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:516 QUINTARD AVE
Mailing Address - Street 2:
Mailing Address - City:ANNISTON
Mailing Address - State:AL
Mailing Address - Zip Code:36201-5711
Mailing Address - Country:US
Mailing Address - Phone:256-741-9799
Mailing Address - Fax:256-741-9795
Practice Address - Street 1:3686 GRANDVIEW PKWY STE 710
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35243-3408
Practice Address - Country:US
Practice Address - Phone:205-723-0395
Practice Address - Fax:205-201-6055
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-20
Last Update Date:2019-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-062957363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics