Provider Demographics
NPI:1184243578
Name:SPURLOCK-WHITE, SHELIA (RN)
Entity type:Individual
Prefix:
First Name:SHELIA
Middle Name:
Last Name:SPURLOCK-WHITE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6125 MONTROSE RD
Mailing Address - Street 2:
Mailing Address - City:CHEVERLY
Mailing Address - State:MD
Mailing Address - Zip Code:20785-1210
Mailing Address - Country:US
Mailing Address - Phone:202-716-3880
Mailing Address - Fax:
Practice Address - Street 1:6125 MONTROSE RD
Practice Address - Street 2:
Practice Address - City:CHEVERLY
Practice Address - State:MD
Practice Address - Zip Code:20785-1210
Practice Address - Country:US
Practice Address - Phone:202-716-3880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-15
Last Update Date:2020-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN61024163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse