MEDICARE: LYNNE MARIE SPADINGER

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	163WC0200X	Critical Care Medicine Registered Nurse	RN508369	CA
2	163W00000X	Registered Nurse	RN69194	NV
3	163W00000X	Registered Nurse	RN166522	AZ

General Provider Information

NPI Number	:	1730458951
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LYNNE MARIE SPADINGER

Provider Business Mailing Address
First Line	:	2601 S PAVILION CENTER DR UNIT 1134
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89135-1843
Country	:	US
Telephone Number	:	858-395-3593
Fax Number	:

Provider Business Practice Location Address
First Line	:	2601 S PAVILION CENTER DR UNIT 1134
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89135-1843
Country	:	US
Telephone Number	:	858-395-3593
Fax Number	:

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

Provider Enumeration Date	:	12/16/2011
Last Update Date	:	12/16/2011

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Directions to “ LYNNE MARIE SPADINGER ” Practice Location

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