Basic Information
| Provider Information | |||||||||
| NPI: | 1922064526 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SPIZZIRRI | ||||||||
| FirstName: | LINDA | ||||||||
| MiddleName: | J | ||||||||
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| Credential: | CRNA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 660 ACKERMAN 3RD FLOOR | ||||||||
| Address2: | PO BOX 183103 | ||||||||
| City: | COLUMBUS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 432163103 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6142932150 | ||||||||
| FaxNumber: | 6142936479 | ||||||||
| Practice Location | |||||||||
| Address1: | 410 WEST TENTH AVENUE | ||||||||
| Address2: | N429 DOAN HALL | ||||||||
| City: | COLUMBUS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 43210 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6142934705 | ||||||||
| FaxNumber: | 6142938153 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/22/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | NA03151 | OH | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered | 367500000X | RN209226 | OH | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
ID Information
| ID | Type | State | Issuer | Description | 2065107 | 05 | OH | MEDICAID |