Individual
MICHELLE SPENCER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1525 W 2100 S, SALT LAKE CITY, UT 84119-1401
(801) 213-9900
Mailing address
PO BOX 510708, SALT LAKE CITY, UT 84151-0708
(801) 213-3900
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
189808-4405
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
500004246
RAILROAD MEDICARE
UT
Enumeration date
10/25/2006
Last updated
11/18/2021
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