Individual
JENNIFER LORRAINE SPICER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1223 GATEWAY DR, MELBOURNE, FL 32901-2607
(321) 434-9561
(321) 434-9231
Mailing address
3300 S FISKE BLVD, ROCKLEDGE, FL 32955-4306
(321) 434-9561
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APRN3385012
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
105141800
—
FL
01
—
QG417
HFMG MA
FL
Enumeration date
01/08/2018
Last updated
11/04/2024
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