Most Relevant Information
Provider Data
| NPI Number: | 1003564675 |
| Provider Name: | ELIZABETH GRACE SPEAR CRNP |
| Entity Type: | Individual |
| Taxonomy Code: | 363LA2100X |
| Specialty: | Nurse Practitioner |
| License Number: | SP020542 |
Most Important Dates
| Enumeration Date: | 03/14/2022 |
| Last Updated: | 06/21/2022 |
Provider Practice Location
3400 SPRUCE ST
PHILADELPHIA
PA
191044238
Practice Location Phone/Fax
| Phone: | 2156622366 |
| Fax: | 2153498235 |
Provider Mailing Location
3400 SPRUCE STREET
3 RAVDIN BLDG. STE F
PHILADELPHIA
PA
191044206
Provider Mailing Phone/Fax
| Phone: | 2156623202 |
| Fax: | 2153498432 |