Individual
MARY LAUREN SPENCER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
615 S NEW BALLAS RD, CREVE COEUR, MO 63141
(314) 251-6000
Mailing address
2905 SWEET FLAG CT, DARDENNE PRAIRIE, MO 63368-9734
(314) 550-6695
Taxonomy
Speciality
Code
Description
License number
State
163WN0002X
Neonatal Intensive Care Registered Nurse
2008020275
MO
363LN0005X
Critical Care Neonatal Nurse Practitioner
Primary
2018025958
MO
Other
Enumeration date
05/01/2018
Last updated
06/09/2021
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