Provider Demographics
NPI:1710969035
Name:SPALDING, PATRICIA NORDSTROM (AUD)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:NORDSTROM
Last Name:SPALDING
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5972 N NEW JERSEY ST
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46220-2514
Mailing Address - Country:US
Mailing Address - Phone:317-253-5829
Mailing Address - Fax:317-259-8083
Practice Address - Street 1:1000 S MAIN ST
Practice Address - Street 2:TIPTON HOSPITAL, SUITE C
Practice Address - City:TIPTON
Practice Address - State:IN
Practice Address - Zip Code:46072-9753
Practice Address - Country:US
Practice Address - Phone:765-675-1405
Practice Address - Fax:765-675-8242
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-14
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN23000502A231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000010494OtherMPLAN AUDIOLOGY
IN000000340777OtherANTHEM AUDIOLOGY
IN000000010494OtherMPLAN AUDIOLOGY