Provider Demographics
NPI:1700186251
Name:SPURGEON, CARLA ELAINE (FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:CARLA
Middle Name:ELAINE
Last Name:SPURGEON
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 OLD WEISGARBER RD
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37909-1291
Mailing Address - Country:US
Mailing Address - Phone:865-584-2146
Mailing Address - Fax:
Practice Address - Street 1:1300 OLD WEISGARBER RD
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37909-1291
Practice Address - Country:US
Practice Address - Phone:865-584-2146
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-01
Last Update Date:2020-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN146340163W00000X
TNAPN15302363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1521709Medicaid
TN1035I07706OtherMEDICARE PTAN
TNP01923702OtherRRMEDICARE PTAN
TNP01923702OtherRRMEDICARE PTAN