Individual
MRS. DEANNA AMBER SPENCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
120 N COUNTRY RD, PORT JEFFERSON, NY 11777-2604
(631) 474-7461
Mailing address
8 ROBERT CT, SHOREHAM, NY 11786-1926
(631) 316-2397
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
343365
NY
Other
Enumeration date
07/23/2018
Last updated
07/23/2018
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