Provider Demographics
NPI:1417926460
Name:SPURLING, AMY JOAN (APRN BC)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:JOAN
Last Name:SPURLING
Suffix:
Gender:F
Credentials:APRN BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:IN
Mailing Address - Zip Code:47670
Mailing Address - Country:US
Mailing Address - Phone:812-386-7522
Mailing Address - Fax:812-386-1097
Practice Address - Street 1:410 N MAIN ST
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:IN
Practice Address - Zip Code:47670
Practice Address - Country:US
Practice Address - Phone:812-386-7522
Practice Address - Fax:812-386-1097
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71000392A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000385862OtherANTHEM BCBS
P21955Medicare UPIN
IN281850IMedicare ID - Type Unspecified