Organization
GROUNDEDSIS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IVANA SPENCER APRN,PMHNP-BC (OWNER)
(804) 825-2308
Entity
Organization
Contact information
Practice address
6372 MECHANICSVILLE TPKE STE 111, MECHANICSVILLE, VA 23111-4705
(804) 825-2308
(804) 964-9870
Mailing address
1601 WILLOW LAWN DR STE 304, RICHMOND, VA 23230-3423
(804) 825-2308
(804) 964-9870
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
12/29/2025
Last updated
12/29/2025
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