Provider Demographics
NPI:1881108785
Name:SPURGUS, NANCY CAROLE
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:CAROLE
Last Name:SPURGUS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 553
Mailing Address - Street 2:
Mailing Address - City:NEW LEXINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43764-0553
Mailing Address - Country:US
Mailing Address - Phone:740-605-3174
Mailing Address - Fax:
Practice Address - Street 1:5076 PARAGON DR SE
Practice Address - Street 2:
Practice Address - City:NEW LEXINGTON
Practice Address - State:OH
Practice Address - Zip Code:43764-9726
Practice Address - Country:US
Practice Address - Phone:740-605-3174
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-30
Last Update Date:2017-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLPN.136706.MEDS-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse