Healthcare Provider Details

I. General information

NPI: 1811819469
Provider Name (Legal Business Name): JASON LEE SPURLOCK APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7300 BEECHMONT AVE
CINCINNATI OH
45230-4119
US

IV. Provider business mailing address

215 BUCK RUN RD
SEAMAN OH
45679-9634
US

V. Phone/Fax

Practice location:
  • Phone: 513-232-9100
  • Fax:
Mailing address:
  • Phone: 907-631-9261
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.0042851
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: