Individual
IVANA SPENCER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1601 WILLOW LAWN DR STE 304, THE SHOPS AT WILLOW LAWN #1283, RICHMOND, VA 23230-3423
(804) 825-2308
(804) 964-9870
Mailing address
1601 WILLOW LAWN DR, STE. 304, THE SHOPS AT WILLOW LAWN #1283, RICHMOND, VA 23230-3427
(757) 793-9483
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
0001284498
VA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
0024194447
VA
Other
Enumeration date
05/21/2025
Last updated
12/04/2025
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