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General NPI Number Information
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NPI Number | 1477875144
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Entity Type | Individual
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Provider Name | RICHARD JASON SPURLOCK CRNA
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Gender | Male
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Dates
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Enumeration Date | 02/23/2010
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Last Update Date | 01/12/2022
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Provider Practice Location Address
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Address Line | 1300 MICCOSUKEE RD
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City | TALLAHASSEE
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State | FL
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Zip | 32308-5054
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Country | US
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Telephone | 850-491-2944
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Fax |
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Provider Business Mailing Address
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Address Line | 8428 IVY BROOK LN
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City | TALLAHASSEE
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State | FL
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Zip | 32312-7034
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Country | US
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Telephone | 850-491-2944
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MA28265
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN9391642
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | APRN11017454
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License Number State | FL
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