| Doctor Name: | KRISTAL LARE SPENCER |
| NPI Number: | 1023444551 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP |
| License Number: | 702355 |
| Business Practice Address: | 719 W Coke Rd Ste 6 Winnsboro, TX - 754943060 |
| Business Phone Number: | 9033423760 |
| Business Fax Number: | |
| Mailing Address: | Po Box 846098, DALLAS |
| State: | TX |
| Postal Code: | 752846098 |
| Phone Number: | 9033246400 |
| Fax Number: | |
| NPI Enumeration Date: | 09/16/2013 |
| NPI Last Update Date: | 06/01/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 702355 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |