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General NPI Number Information
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NPI Number | 1306565437
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Entity Type | Individual
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Provider Name | SYDNEY GABRIELLE SPURGEON PA-C
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Gender | Female
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Dates
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Enumeration Date | 08/23/2022
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Last Update Date | 08/23/2022
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Provider Practice Location Address
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Address Line | 1411 W BADDOUR PKWY
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City | LEBANON
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State | TN
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Zip | 37087-2513
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Country | US
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Telephone | 615-444-8262
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Fax |
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Provider Business Mailing Address
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Address Line | 634 EMORY RIVER RD
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City | HARRIMAN
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State | TN
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Zip | 37748-5005
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Country | US
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Telephone | 865-335-8850
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number |
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License Number State |
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