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Individual
KRISTEN SPENCER
Active
Individual
KRISTEN SPENCER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
C0005643
MD
363A00000X
Physician Assistant
Primary
PA2363
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300017942
—
IN
05
—
7100543980
—
KY
Enumeration date
02/04/2015
Last updated
04/22/2022
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