Provider Demographics
NPI:1083842983
Name:SPAGNOLA, LINDA D (RN, BSN, CDE)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:D
Last Name:SPAGNOLA
Suffix:
Gender:F
Credentials:RN, BSN, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1002 N CHURCH ST STE 400
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27401-1450
Mailing Address - Country:US
Mailing Address - Phone:336-378-1076
Mailing Address - Fax:336-378-0867
Practice Address - Street 1:1002 N CHURCH ST STE 400
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401-1450
Practice Address - Country:US
Practice Address - Phone:336-378-1076
Practice Address - Fax:336-378-0867
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-30
Last Update Date:2013-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC72654163W00000X
NC0862-1056163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator
No163W00000XNursing Service ProvidersRegistered Nurse