Healthcare Provider Details

I. General information

NPI: 1922420124
Provider Name (Legal Business Name): SHELBY NICOLE SPURLIN CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/08/2014
Last Update Date: 07/30/2020
Certification Date: 07/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 E 10TH ST
ANNISTON AL
36207-4716
US

IV. Provider business mailing address

3860 FRIENDSHIP RD
OXFORD AL
36203-4901
US

V. Phone/Fax

Practice location:
  • Phone: 256-235-5211
  • Fax:
Mailing address:
  • Phone: 256-310-4683
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1-123708
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number1-123708
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: