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Individual

WILMA J SPENCER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
7724 N KINGS HWY, MYRTLE BEACH, SC 29572-3041
(843) 663-1013
(843) 663-1017
Mailing address
PO BOX 547, LITTLE RIVER, SC 29566-0547
(843) 663-1013
(843) 663-1017

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R78330
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
57-0672117
TAX ID #
SC
Enumeration date
04/25/2007
Last updated
01/27/2011
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