Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 7124 | LA |
N | 1223D0001X | Dental Public Health | 7124 | LA |
N | 1223G0001X | General Practice | 7124 | LA |
N | 213EG0000X | General Practice | 7124 | LA |
NPI | 1487217337 |
---|---|
Provider Name | Dr. Amber Nekol Spurlock |
First Address | Donaldsonville, LA 70346-4167 |
Second Address | Lutcher, LA 70071-5119 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2019 |
Last Update Date | 14/02/2022 |