=====================================================
General NPI Number Information
=====================================================
NPI Number | 1811819469
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JASON LEE SPURLOCK APRN
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/27/2026
-----------------------------------------------------
Last Update Date | 07/27/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7300 BEECHMONT AVE
-----------------------------------------------------
City | CINCINNATI
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45230-4119
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 513-232-9100
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 215 BUCK RUN RD
-----------------------------------------------------
City | SEAMAN
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45679-9634
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 907-631-9261
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | APRN.CNP.0042851
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------