Healthcare Provider Details

I. General information

NPI: 1235059239
Provider Name (Legal Business Name): MARTIANA SPURLOCK
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15703 TURNEY RD
MAPLE HEIGHTS OH
44137-4861
US

IV. Provider business mailing address

15703 TURNEY RD
MAPLE HEIGHTS OH
44137-4861
US

V. Phone/Fax

Practice location:
  • Phone: 216-509-2512
  • Fax:
Mailing address:
  • Phone: 216-509-2512
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License Number541036
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: