MEDICARE: MAKENZIE ELIZABETH SPURGEON RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WX0800X	Orthopedic Registered Nurse	0000293133	TN

General Provider Information

NPI Number	:	1942838495
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAKENZIE ELIZABETH SPURGEON RN

Provider Business Mailing Address
First Line	:	8924 FOX LAKE DR
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37923-6479
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1924 ALCOA HWY
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37920-6900
Country	:	US
Telephone Number	:	865-368-7611
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/31/2020
Last Update Date	:	03/31/2020

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