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Individual
KELLY MARIE PURCELL
Active
Individual
KELLY MARIE PURCELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
TL4762
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
047620
—
SC
Enumeration date
06/09/2006
Last updated
07/31/2014
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