MR. Spencer Waller, FNP

NPI #1033629241 in Pueblo, Colorado

Provider Information

NPI Number
1033629241
Entity Type
Individual
Name
MR. Spencer Waller, FNP
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Nurse Practitioner
Credential
FNP
Enumeration Date
Oct 3, 2017
Last Updated
Mar 29, 2018

Practice Location

Address
400 W 16TH ST
City
Pueblo
ZIP Code
81003-2781
Phone
(719) 584-4306

Specialties & Taxonomy Codes

Specialty
Nurse Practitioner

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