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General NPI Number Information
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NPI Number | 1336446616
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Entity Type | Individual
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Provider Name | LOURDES SPINOLA PA-C
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Gender | Female
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Dates
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Enumeration Date | 02/22/2011
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Last Update Date | 10/25/2018
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Provider Practice Location Address
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Address Line | 6945 TUTT BLVD
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City | COLORADO SPRINGS
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State | CO
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Zip | 80923-3566
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Country | US
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Telephone | 719-380-7325
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Fax |
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Provider Business Mailing Address
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Address Line | 7600 E CALEY AVE APT 1031
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City | ENGLEWOOD
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State | CO
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Zip | 80111-6779
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA07201
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0005370
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License Number State | CO
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