| Doctor Name: | MS. PICCINA R SPENCE |
| NPI Number: | 1417949082 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PA-C |
| License Number: | 02958 |
| Business Practice Address: | 192 Lindquist Rd Bld 412, Tfcmc Ft Stewart, GA - 313145122 |
| Business Phone Number: | 9124356633 |
| Business Fax Number: | |
| Mailing Address: | 1061 Harmon Ave, Suite 1d03, Winn Army Community Hospital FT. STEWART |
| State: | GA |
| Postal Code: | 31315 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 08/18/2005 |
| NPI Last Update Date: | 10/01/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 02958 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |