Individual
MR. SPENCER R GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1336 FIVE CENT RD, WILLIAMSTON, NC 27892-8412
(252) 343-6677
Mailing address
1336 FIVE CENT RD, WILLIAMSTON, NC 27892-8412
(252) 343-6677
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
149935
NC
367500000X
Certified Registered Nurse Anesthetist
051808
NC
367500000X
Certified Registered Nurse Anesthetist
Primary
2449
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8051543
—
NC
Enumeration date
08/10/2006
Last updated
04/22/2022
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