Provider Demographics
NPI:1073306007
Name:SPURR, MAYRA VERONICA
Entity type:Individual
Prefix:
First Name:MAYRA
Middle Name:VERONICA
Last Name:SPURR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MAYRA
Other - Middle Name:
Other - Last Name:ALVAREZ PONCE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PMHNP
Mailing Address - Street 1:9355 S POLO CT
Mailing Address - Street 2:
Mailing Address - City:HEREFORD
Mailing Address - State:AZ
Mailing Address - Zip Code:85615-8414
Mailing Address - Country:US
Mailing Address - Phone:480-252-1351
Mailing Address - Fax:
Practice Address - Street 1:9355 S POLO CT
Practice Address - Street 2:
Practice Address - City:HEREFORD
Practice Address - State:AZ
Practice Address - Zip Code:85615-8414
Practice Address - Country:US
Practice Address - Phone:480-252-1351
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-23
Last Update Date:2025-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2025020629363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty