Provider Demographics
NPI:1679324701
Name:SPURGEON, WILLIAM WALKER (NP)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:WALKER
Last Name:SPURGEON
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10796 N LA COSTA
Mailing Address - Street 2:
Mailing Address - City:CEDAR HILLS
Mailing Address - State:UT
Mailing Address - Zip Code:84062-8076
Mailing Address - Country:US
Mailing Address - Phone:626-498-6192
Mailing Address - Fax:
Practice Address - Street 1:10796 N LA COSTA
Practice Address - Street 2:
Practice Address - City:CEDAR HILLS
Practice Address - State:UT
Practice Address - Zip Code:84062-8076
Practice Address - Country:US
Practice Address - Phone:626-498-6192
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-27
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT13498574-4405363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily