Most Relevant Information
Provider Data
| NPI Number: | 1003272204 |
| Provider Name: | LISA ELLEN SPENCER APRN |
| Entity Type: | Individual |
| Taxonomy Code: | 363LG0600X |
| Specialty: | Nurse Practitioner |
| License Number: | 3009949 |
Most Important Dates
| Enumeration Date: | 01/05/2016 |
| Last Updated: | 10/19/2017 |
Provider Practice Location
613 23RD ST STE 230
ASHLAND
KY
411012868
Practice Location Phone/Fax
| Phone: | 6063244745 |
| Fax: | 6063244941 |
Provider Mailing Location
PO BOX 2379
ASHLAND
KY
411052379
Provider Mailing Phone/Fax
| Phone: | 6064086200 |
| Fax: | 6064086612 |