Provider Demographics
NPI:1841380755
Name:SPANGENBERG, LINDA HOPE (FNP)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:HOPE
Last Name:SPANGENBERG
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1602 N 37TH ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103-8225
Mailing Address - Country:US
Mailing Address - Phone:720-212-7455
Mailing Address - Fax:
Practice Address - Street 1:260 S KIPLING ST
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80226-1086
Practice Address - Country:US
Practice Address - Phone:303-232-6301
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO96842363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO96842OtherRN LICENSE NUMBER
CO363LF0000XMedicaid
CO363LF0000XMedicaid