Individual
MARY FULTZ SPENCER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5711 SIX FORKS RD STE 200, RALEIGH, NC 27609-3888
(919) 845-1555
(919) 845-1558
Mailing address
5711 SIX FORKS RD STE 200, RALEIGH, NC 27609-3888
(919) 845-1555
(919) 845-1558
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
073345
NC
Other
Enumeration date
03/11/2007
Last updated
07/08/2007
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