Provider Demographics
NPI:1801880224
Name:SPENCER, LAURA P (RPH)
Entity type:Individual
Prefix:MS
First Name:LAURA
Middle Name:P
Last Name:SPENCER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 TALBOTT DR
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42103-1322
Mailing Address - Country:US
Mailing Address - Phone:270-796-8844
Mailing Address - Fax:
Practice Address - Street 1:150 TALBOTT DR
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42103-1322
Practice Address - Country:US
Practice Address - Phone:270-796-8844
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY6972183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist