Whip cream cheese, powdered sugar and vanilla together in a medium bowl until smooth and fluffy. Set aside. Mix pumpkin and remaining spices together. Set aside.
Apply generous amount of cream cheese mixture to one piece of bread. Apply generous amount of pumpkin mixture to the other piece of bread. Place together like a sandwich.
Beat 3 eggs, 3/4 cup cream or milk, 1/4 teaspoon nutmeg and a dash of vanilla together in a wide bowl. Dip French toast sandwich in the egg mixture and cook on gridle until golden brown on both sides. Sprinkle with powdered sugar and garnish with whipped cream.
Alternate garnish: Mix two or three tablespoons of the pumpkin mixture with 1/2 cup cream or whipped cream. Add one beaten egg and 1/4 cup sugar. Cook on top of stove stirring constantly until thick and creamy. Use this pumpkin custard as a sauce served over the French toast.