Provider Demographics
NPI:1013025840
Name:SPOONER, LINDA LOUISE (APRN)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:LOUISE
Last Name:SPOONER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2330 ARLINGTON ST
Mailing Address - Street 2:
Mailing Address - City:ADA
Mailing Address - State:OK
Mailing Address - Zip Code:74820-2823
Mailing Address - Country:US
Mailing Address - Phone:580-332-2011
Mailing Address - Fax:580-332-9537
Practice Address - Street 1:2330 ARLINGTON ST
Practice Address - Street 2:
Practice Address - City:ADA
Practice Address - State:OK
Practice Address - Zip Code:74820-2823
Practice Address - Country:US
Practice Address - Phone:580-332-2011
Practice Address - Fax:580-332-9537
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2011-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK97516363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK97516OtherAPRN