Healthcare Provider Details

I. General information

NPI: 1902962780
Provider Name (Legal Business Name): GLENDA SPAULDING RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/28/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

69 ANIMAL RD
ROWLAND NC
28383-9368
US

IV. Provider business mailing address

69 ANIMAL RD
ROWLAND NC
28383-9368
US

V. Phone/Fax

Practice location:
  • Phone: 910-521-3558
  • Fax: 910-521-7257
Mailing address:
  • Phone: 910-521-3558
  • Fax: 910-521-7257

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberHC3219
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: