Individual
MARY ELIZABETH SPURLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
9900 BREN RD E, MINNETONKA, MN 55343-9664
(606) 831-3619
Mailing address
9900 BREN RD E, MINNETONKA, MN 55343-9664
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
07668-NP
OH
363LF0000X
Family Nurse Practitioner
Primary
3004127
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0264253
—
OH
05
—
0307649
—
OH
05
—
0632944
—
OH
05
—
78018140
—
KY
01
—
P00207334
RR MEDICARE
KY
Enumeration date
09/25/2006
Last updated
06/29/2020
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