Individual
MR. PATRICK G SPENCER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
4465 WHITE BEAR PARKWAY, WHITE BEAR LAKE, MN 55110
(651) 653-0062
(651) 653-0288
Mailing address
4465 WHITE BEAR PARKWAY, WHITE BEAR LAKE, MN 55110
(651) 653-0062
(651) 653-0288
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R106819-3
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
348618400
—
MN
Enumeration date
10/02/2006
Last updated
07/21/2022
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