Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | 26NJ00615700 | NJ |
N | 363LA2200X | Nurse Practitioner - Adult Health | 26NJ00615700 | NJ |
Y | 363LG0600X | Nurse Practitioner - Gerontology | 26NJ00615700 | NJ |
NPI | 1003275140 |
---|---|
Provider Name | Marline Spencer |
First Address | Franklin Park, NJ 08823-1662 |
Second Address | Edison, NJ 08820-3947 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/02/2016 |
Last Update Date | 21/06/2019 |