Basic Information
Provider Information
NPI: 1548366099
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SPUGNARDI
FirstName: LOUISE
MiddleName: A
NamePrefix: MS.
NameSuffix:  
Credential: NP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 110 ROUTT AVE
Address2:  
City: PUEBLO
State: CO
PostalCode: 81004
CountryCode: US
TelephoneNumber: 7195438711
FaxNumber: 7195435340
Practice Location
Address1: 300 COLORADO AVE
Address2:  
City: PUEBLO
State: CO
PostalCode: 810042006
CountryCode: US
TelephoneNumber: 7195438711
FaxNumber: 7195435340
Other Information
ProviderEnumerationDate: 09/15/2006
LastUpdateDate: 02/06/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
164W00000X115951COY Nursing Service ProvidersLicensed Practical Nurse 

No ID Information.


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