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CHAD G SPENCER FNP-C

>> Nurse Practitioner >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1891387858

Individual Registrant:
 CHAD G SPENCER FNP-C
Gender: M
Sole Proprietor

Location and contact information for practice:
15215 S ROCKET DR  BLUFFDALE, UT 84065-4935 US
Tel: 801-856-6414  Fax: --

Contact information for business:
15215 S ROCKET DR  BLUFFDALE, UT 84065-4935 US
Tel: 801-856-6414  Fax: --

Registration Information:
NPI: 1891387858
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y363L00000XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
UTF12200933

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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