Individual
COLLEEN THAXTON SPENCER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
11100 EUCLID AVE, CLEVELAND, OH 44106-1716
(216) 844-7334
(216) 844-3781
Mailing address
3605 WARRENSVILLE CENTER RD, 1ST FLOOR, SHAKER HTS, OH 44122-5203
(216) 286-6260
(216) 286-6341
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN.301245
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2966910
—
OH
01
—
P00785737
MEDICARE RAILROAD
OH
Enumeration date
07/01/2009
Last updated
03/01/2010
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