Provider Demographics
NPI:1114465283
Name:SPURGIN, JESSIE (MS, CCC -SLP)
Entity Type:Individual
Prefix:MS
First Name:JESSIE
Middle Name:
Last Name:SPURGIN
Suffix:
Gender:F
Credentials:MS, CCC -SLP
Other - Prefix:
Other - First Name:JESSIE
Other - Middle Name:
Other - Last Name:MCAFEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CFY -SLP
Mailing Address - Street 1:1100 N KENTUCKY AVE
Mailing Address - Street 2:
Mailing Address - City:WEST PLAINS
Mailing Address - State:MO
Mailing Address - Zip Code:65775-2029
Mailing Address - Country:US
Mailing Address - Phone:417-257-5959
Mailing Address - Fax:417-257-5814
Practice Address - Street 1:1100 N KENTUCKY AVE
Practice Address - Street 2:
Practice Address - City:WEST PLAINS
Practice Address - State:MO
Practice Address - Zip Code:65775-2029
Practice Address - Country:US
Practice Address - Phone:417-257-5959
Practice Address - Fax:417-257-5814
Is Sole Proprietor?:No
Enumeration Date:2017-02-08
Last Update Date:2019-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2017002926235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist