Healthcare Provider Details

I. General information

NPI: 1083842983
Provider Name (Legal Business Name): LINDA D. SPAGNOLA RN, BSN, CDE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/30/2009
Last Update Date: 11/06/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1002 N CHURCH ST STE 400
GREENSBORO NC
27401-1450
US

IV. Provider business mailing address

1002 N CHURCH ST STE 400
GREENSBORO NC
27401-1450
US

V. Phone/Fax

Practice location:
  • Phone: 336-378-1076
  • Fax: 336-378-0867
Mailing address:
  • Phone: 336-378-1076
  • Fax: 336-378-0867

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number72654
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code163WD0400X
TaxonomyDiabetes Educator Registered Nurse
License Number0862-1056
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: