Provider Demographics
NPI:1235620527
Name:SPENCER, PRECIOUS MONIQUE (PMHNP-BC, APRN)
Entity type:Individual
Prefix:MS
First Name:PRECIOUS
Middle Name:MONIQUE
Last Name:SPENCER
Suffix:
Gender:F
Credentials:PMHNP-BC, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1420 CELEBRATION BLVD
Mailing Address - Street 2:
Mailing Address - City:CELEBRATION
Mailing Address - State:FL
Mailing Address - Zip Code:34747-5159
Mailing Address - Country:US
Mailing Address - Phone:800-614-4124
Mailing Address - Fax:888-684-2566
Practice Address - Street 1:1420 CELEBRATION BLVD STE 200
Practice Address - Street 2:
Practice Address - City:CELEBRATION
Practice Address - State:FL
Practice Address - Zip Code:34747-5162
Practice Address - Country:US
Practice Address - Phone:407-676-4276
Practice Address - Fax:888-684-2566
Is Sole Proprietor?:No
Enumeration Date:2018-05-23
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704247506163W00000X
MI18312081156363LP0808X
FLAPRN11000203363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse