Provider Demographics
NPI:1982992830
Name:SPURLOCK, MEGAN AARYN (APN)
Entity Type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:AARYN
Last Name:SPURLOCK
Suffix:
Gender:F
Credentials:APN
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 1960
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72403-1960
Mailing Address - Country:US
Mailing Address - Phone:870-240-8402
Mailing Address - Fax:870-240-8833
Practice Address - Street 1:4700 W KINGSHIGHWAY
Practice Address - Street 2:
Practice Address - City:PARAGOULD
Practice Address - State:AR
Practice Address - Zip Code:72450-3465
Practice Address - Country:US
Practice Address - Phone:870-240-8402
Practice Address - Fax:870-240-8833
Is Sole Proprietor?:No
Enumeration Date:2011-07-13
Last Update Date:2016-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA03577363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily