Provider Demographics
NPI:1710139845
Name:SPURLIN, ADA K (RN)
Entity Type:Individual
Prefix:
First Name:ADA
Middle Name:K
Last Name:SPURLIN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:ADA
Other - Middle Name:K
Other - Last Name:KIDWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 787
Mailing Address - Street 2:
Mailing Address - City:TALKEETNA
Mailing Address - State:AK
Mailing Address - Zip Code:99676-0787
Mailing Address - Country:US
Mailing Address - Phone:907-733-2273
Mailing Address - Fax:
Practice Address - Street 1:MILE 4.4 TALKEETNA SPUR ROAD
Practice Address - Street 2:
Practice Address - City:TALKEENTA
Practice Address - State:AK
Practice Address - Zip Code:99676-0000
Practice Address - Country:US
Practice Address - Phone:907-733-2273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-21
Last Update Date:2008-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK24782163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse