NPI | 1558436774 |
---|---|
Former Name | TIFFANY D. PURCELL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: MD AC000410) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MD AC000410) |
Enumeration Date | 2006-11-22 |
Last Update Date | 2011-01-31 |