Provider Demographics
NPI:1902962780
Name:SPAULDING, GLENDA (RN)
Entity Type:Individual
Prefix:
First Name:GLENDA
Middle Name:
Last Name:SPAULDING
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:69 ANIMAL RD
Mailing Address - Street 2:
Mailing Address - City:ROWLAND
Mailing Address - State:NC
Mailing Address - Zip Code:28383-9368
Mailing Address - Country:US
Mailing Address - Phone:910-521-3558
Mailing Address - Fax:910-521-7257
Practice Address - Street 1:69 ANIMAL RD
Practice Address - Street 2:
Practice Address - City:ROWLAND
Practice Address - State:NC
Practice Address - Zip Code:28383-9368
Practice Address - Country:US
Practice Address - Phone:910-521-3558
Practice Address - Fax:910-521-7257
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-28
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC3219163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3418165Medicaid
NC6601483Medicaid