Individual
JENNIFER L SPICER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, PA-C
Contact information
Practice address
374 MOUNTAIN BLVD, WERNERSVILLE, PA 19565-9219
(570) 561-2990
Mailing address
965 RYE VALLEY RD, MEADOWBROOK, PA 19046-1323
(215) 847-0820
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
MA053239
PA
363AM0700X
Medical Physician Assistant
Primary
MA053239
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25MP00223400
NJ LICENSE
NJ
01
—
MA053239
LICENSE NUMBER
PA
01
—
OA004417
PENNSYLVANIA STATE BOARD OF MEDICINE
PA
Enumeration date
01/08/2008
Last updated
04/08/2025
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