Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | 97516 | OK |
NPI | 1013025840 |
---|---|
Provider Name | Mrs. Linda Louise Spooner |
First Address | Ada, OK 74820-2823 |
Second Address | Ada, OK 74820-2823 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/08/2006 |
Last Update Date | 04/11/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
97516 | APRN (01) | OK |