Provider Demographics
NPI:1144096058
Name:SPENCER, KAMI (CST, CSFA)
Entity type:Individual
Prefix:
First Name:KAMI
Middle Name:
Last Name:SPENCER
Suffix:
Gender:F
Credentials:CST, CSFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5076 32ND ST
Mailing Address - Street 2:
Mailing Address - City:GREELEY
Mailing Address - State:CO
Mailing Address - Zip Code:80634-8720
Mailing Address - Country:US
Mailing Address - Phone:480-381-4091
Mailing Address - Fax:
Practice Address - Street 1:6767 29TH ST
Practice Address - Street 2:
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80634-5474
Practice Address - Country:US
Practice Address - Phone:480-381-4091
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-01
Last Update Date:2023-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant