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General NPI Number Information
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NPI Number | 1700447265
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Entity Type | Individual
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Provider Name | SAMANTHA NICOLE SPURGEON
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Gender | Female
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Dates
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Enumeration Date | 06/25/2019
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Last Update Date | 02/11/2025
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Provider Practice Location Address
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Address Line | 902 GALLIA ST
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City | PORTSMOUTH
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State | OH
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Zip | 45662-4139
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Country | US
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Telephone | 740-961-0882
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Fax |
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Provider Business Mailing Address
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Address Line | 902 GALLIA ST
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City | PORTSMOUTH
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State | OH
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Zip | 45662-4139
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Country | US
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Telephone | 740-529-2125
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 191705
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License Number State | OH
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