Provider Demographics
NPI:1386024826
Name:SPURLOCK-PERKINS, ANGEL (RN)
Entity Type:Individual
Prefix:
First Name:ANGEL
Middle Name:
Last Name:SPURLOCK-PERKINS
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 1:9818 YELLOWSTONE AVE
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70814-4347
Mailing Address - Country:US
Mailing Address - Phone:225-278-3886
Mailing Address - Fax:
Practice Address - Street 1:9818 YELLOWSTONE AVE
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70814-4347
Practice Address - Country:US
Practice Address - Phone:225-278-3886
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-29
Last Update Date:2015-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN117565163WN0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WN0002XNursing Service ProvidersRegistered NurseNeonatal Intensive Care