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Individual

NICOLE MARIE SPENCER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
11850 BLACKFOOT ST NW STE 100, COON RAPIDS, MN 55433-2774
(763) 712-2100
Mailing address
2550 UNIVERSITY AVE W, SAINT PAUL, MN 55114-1052
(651) 602-5335

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
T7051
TX
207VX0201X
Gynecologic Oncology Physician
Primary
80221
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1760973176
CSHCN
TX
05
1760973176
TX
Enumeration date
05/21/2018
Last updated
08/18/2025
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