Doctor Name: | NIKKI SPENCER |
NPI Number: | 1285869198 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMT |
License Number: | MAT6087 |
Business Practice Address: | 64-1061 Mamalahoa Hwy Suite 110 Kamuela, HI - 967438482 |
Business Phone Number: | 8089373013 |
Business Fax Number: | |
Mailing Address: | Po Box 2926, KAMUELA |
State: | HI |
Postal Code: | 967432926 |
Phone Number: | 8089373013 |
Fax Number: | |
NPI Enumeration Date: | 05/20/2009 |
NPI Last Update Date: | 05/20/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | MAT6087 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | HI |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |