Basic Information
Provider Information | |||||||||
NPI: | 1538669270 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | SPENCER-HILL | ||||||||
FirstName: | EUSTACIER | ||||||||
MiddleName: |   | ||||||||
NamePrefix: | MRS. | ||||||||
NameSuffix: |   | ||||||||
Credential: | FNP | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: | SPENCER | ||||||||
OtherFirstName: | EUSTACIER | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: | MS. | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: | FNP-BC | ||||||||
OtherLastNameType: | 1 | ||||||||
Mailing Information | |||||||||
Address1: | 73 MOORE RD | ||||||||
Address2: |   | ||||||||
City: | HOPEWELL JUNCTION | ||||||||
State: | NY | ||||||||
PostalCode: | 125334300 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 3472781799 | ||||||||
FaxNumber: |   | ||||||||
Practice Location | |||||||||
Address1: | 45 READE PL | ||||||||
Address2: |   | ||||||||
City: | POUGHKEEPSIE | ||||||||
State: | NY | ||||||||
PostalCode: | 126013947 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 8454836001 | ||||||||
FaxNumber: | 8454836002 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 02/20/2018 | ||||||||
LastUpdateDate: | 06/28/2019 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 645145 | NY | N |   | Nursing Service Providers | Registered Nurse |   | 363LF0000X | 344221 | NY | Y |   | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.