Healthcare Provider Details

I. General information

NPI: 1356671697
Provider Name (Legal Business Name): NADINE LYNN SPRADLEY RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/08/2010
Last Update Date: 01/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

415 N SYCAMORE ST SUITE 200
SANTA ANA CA
92701-4607
US

IV. Provider business mailing address

13572 FLINT DR
SANTA ANA CA
92705-2602
US

V. Phone/Fax

Practice location:
  • Phone: 714-836-5447
  • Fax:
Mailing address:
  • Phone: 714-544-4586
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WW0101X
TaxonomyAmbulatory Women's Health Care Registered Nurse
License Number390460
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: