Provider Demographics
NPI:1659609402
Name:AZZI, LINDA GAIL (RN, BS)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:GAIL
Last Name:AZZI
Suffix:
Gender:F
Credentials:RN, BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3545 GOLDEN SPUR LOOP
Mailing Address - Street 2:
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80108-8463
Mailing Address - Country:US
Mailing Address - Phone:303-674-8448
Mailing Address - Fax:303-674-9894
Practice Address - Street 1:3545 GOLDEN SPUR LOOP
Practice Address - Street 2:
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80108-8463
Practice Address - Country:US
Practice Address - Phone:303-674-8448
Practice Address - Fax:303-674-9894
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-04
Last Update Date:2009-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO39331101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional