MEDICARE: LINDA SPANGLER LPN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	164W00000X	Licensed Practical Nurse	472544	MN

General Provider Information

NPI Number	:	1184442527
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDA SPANGLER LPN

Provider Business Mailing Address
First Line	:	2101 ELM ST N
Second Line	:
City	:	FARGO
State	:	ND
Zip	:	58102-2417
Country	:	US
Telephone Number	:	218-739-1400
Fax Number	:

Provider Business Practice Location Address
First Line	:	1839 N PARK ST
Second Line	:
City	:	FERGUS FALLS
State	:	MN
Zip	:	56537-1247
Country	:	US
Telephone Number	:	218-739-1400
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/02/2024
Last Update Date	:	10/02/2024

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